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INDUSTRIAL HYGIENE PROBLEMS 

in 

BOLIVIA, PERU and CHILE 



Federal Security Agency 


PUBLIC HKALTH SERVICE 







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INDUSTRIAL HYGIENE PROBLEMS 

in 

BOLIVIA, PERU and CHILE 



by J. J. BLOOMFIELD 

SAMrAin KNGINKKR DIRKCTOH 
Assistant Chief 

DIVISION OF INDUSTRIAL HYGIENK 
BlIKKAU OF STATFS SERVICES 


PUBLIC HEALTH 
BULLETIN No.301 


i 


I’RKI’AREI) DIRFC.TION OF THF, SURCfF.ON GKNKRAI, 
Federal Security Agency . l•lJl!l.l(: iikai.tii skhvick 









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UNITED STATES 

GOVERNMENT PRINTING OFFICE 
WASHINGTON : 1948 


For sale by the Superintendent of Documents, Washington, D. C. 


Price 40^ 



Contents 


Page 


Preface. V 

Acknowledgmeiits. VI 


I. Introduction. 1 

Activities of health and sanitation division, IIAA. 1 

Content of reports. 5 

IF. Metliod of study. 6 


IFF. General information. 8 

Economic resources. 8 

I’opulation. 11 

Income . . 12 

Housing and living conditions. 14 

Education. 19 

Community health and sanitation. 21 

Summary. 24 


IV. Health in industry . . . 

Gainfully employed . . . 

Industries surveyed 
Occupational hazards . . 

Mines . 

Manufacturing industries 
Occupational diseases . . 

Safety provisions . . . 

Sanitation facilities . . 

Medical services .... 
Sickness benefits .... 


2o 

25 

27 


29 

29 

39 


42 


49 


52 

5(5 


Cl 


III 



























V. Current activities concerned with industrial hygiene. 66 

Otticial agencies. 

Nunofficial agencies. 

VI. Summary. ' ^ 

VII. Recommendations. 

Bolivia. 

Peru. 86 

Chile.- 82 

Appendix I . 83 

Appendix II.- 85 

Appendix III. 88 


IV 














Preface 

The United States for many years has been active in the conduct of 
industrial hygiene activities. Many visitors come from foreign shores 
every year to study American practices, both in industry and govern¬ 
ment. Our close working relationships with our South American 
neighbors have enabled us to render a further service to them in tlie 
detail of staff personnel, and the following report describes the studies 
of Sanitary Engineer Director J. J. Bloomfield, Assistant Chief of the 
Division of Industrial Hygiene, Public Health Service, in Bolivia, 
Peru, and Chile. The studies were undertaken, and the recommenda¬ 
tions made, at the request of the governments of these countries under 
the auspices of the Institute of Inter-American Affairs. 

This report does not purport to be a typical industrial hygiene study, 
establishing principles and recommendations that may be equally 
applicable elsewhere. It includes a wide sweep of considerations— 
such as various socioeconomic factors—which an industrial hygiene 
study per se normally would not encompass. It also ventures into fields 
outside of the province of the Public Health Service. The promulgation 
and enforcement of codes, such as that drawn up for Bolivia, for 
instance, is traditionally a function of departments of labor or indus¬ 
trial commissions in the United States. 

Paced with the task of developing effective industrial hygiene ])r()- 
grams in Bolivia, Peru, and Chile, our consultant considered all factors 
and measures which were required to formulate a meaningful whole. 
Because of the critical prevalence of disease in these countries, for 
example, any efforts directed at improving the working environment 
without looking at the community scene would have been doomed to 
sterility, ft must therefore be borne in mind that this unusually 
comprehensive study does not set up a model program for general use 
but is rather intended to cover only the situations in Bolivia, Peru, 
and Chile. Based on a thorough investigation of all aspects of indus¬ 
trial life in those countries, it represents an effort to helj) them develo]) 
their rich iiatiiral resources by jiromoting and ])reserviug a most vital 
asset, the health of their working pt'ople. 

J. (J. TowxsF.Ni), Medical Director, 

C'ief. Division of Industrial U]i<jiene, Duhtic Health Service 


V 



Acknowledgments 

Grateful acknowledgment is made to the Health and Sanitation 
Division of the Institute of Inter-American Affairs, under whose 
auspices these industrial hygiene studies originally were made possible. 
We are also indebted to government officials in Bolivia, Peru, and 
Chile for their cooperation in the conduct of the survey and to manage¬ 
ment officials for making their facilities available as study subjects. 

Invaluable assistance toward the completion of this work was con¬ 
tributed by Public Health Analyst Victoria Trasko, of the Division of 
Industrial Hygiene, Public Health Service, who made the statistical 
analyses of the survey data and prepared the tabulations, and by staff 
Information Specialists Frances Balgley and Tula Salpas, who aided 
in the editing, organizing, and presentation of the report. 


VI 


1. Introduction 

Unlike the feverish exploitation of the Klondike, the development 
of South America’s rich natural resources has been marked by a slow, 
steady tempo. Through centuries of effort, it has achieved distinction 
in certain fields, but some of its economic possibilities still lie dormant, 
while others are just now being aroused from their lethargy. 

This pace is mirrored in the debilitated activity of its \vorkers, for 
the serious prevalence of disease saps them of vitality and productivity. 
Another factor to which this low-gear development schedule is in part 
attributable is the lack of a vigorous immigration program. Immigra¬ 
tion, which pumps fresh blood into a nation’s lifeline, consists of a 
mere trickle in Bolivia, Peru, and Chile. Both these factors militate 
against the full tapping of the vast store of natural resources in the 
three countries. The lack of an adequate public health program par¬ 
ticularly impedes progress. Only by a betterment of general living 
conditions will their productive capacity and purchasing power 
increase. 

Toward this end, studies of industrial hygiene problems and con¬ 
ditions were undertaken at the request of the governments of Bolivia, 
Peru, and Chile to recommend ways and means of ameliorating the 
health status of workers. Since these studies—and the resultant recom¬ 
mendations—Were made possible under the auspices of the Division of 
Health and Sanitation of the Institute of Inter-American Affairs, a brief 
description of the origin and work of this division is indicated. 


ACTIVITIES OF THE DIVISION OF HEALTH 
AND SANITATION, HAA 

The health and sanitation program of the Institute of Inter- 
American Affairs, a Federal agency of the United States, was born in 
Rio de Janeiro in January 1942, at the Third Meeting of the Ministers 
of Foreign Affairs for the American Republics. It sprang out of 
resolutions that health and sanitary measures were basic to mobiliza¬ 
tion activities. The program has transcended the war period, however, 
because its functions arc equally vital in time of peace, and health 


1 




and sanitation work is now being carried out in 14 Latin-American 
countries by the governments of those countries and of the United 
States. 

Under the aegis of this program, hospitals, health centers, water 
supply and sewerage systems, and other health and sanitary facilities 
have been constructed. Numerous projects have been undertaken in 
preventive medicine against major disease problems. 

In the industrial hygiene field, however, the only activity up to 
1947 was found in Bolivia. This program was precipitated by a series 
of studies undertaken by the United States at the request of the 
Bolivian Government. A discussion of the program will be found in , 
the following section. 

Bolivia 

The deleterious effect of poor health on production in Bolivia was 
brought out forcefully during the early part of World War II. As 
Bolivia was—and still is—the only source of tin available to the United 
States and the Allies, we were vitally concerned with her production 
schedules. It was soon realized that these schedules were seriously 
hampered by the poor health of Bolivian workers and the unsafe and 
insanitary conditions under which they worked and lived. 

The exigency of war, however, placed prime stress on financial and 
technical considerations in the production of strategic materials. ; 
Attention to the health factor was relegated to a later time, when the i 
Bolivian Government requested the United States to undertake a series J 
of studies with regard to health, sanitation, and other aspects of ' 
Bolivian mining. These studies resulted in the inauguration on October 
1, 1945, of a joint labor program, scheduled to operate for 2 years, i 
The program was integrated into the regular public health program ^ 
operated jointly by the Bolivian Government and the Division of i 
Health and Sanitation of the Institute of Inter-American Affairs. This j 
cooperative health service is known as the Servicio Cooperative Inter-,] 
Americano de Salud Publica, or SCISP. The agreement with regard i 
to the labor program had as its objectives (1) the development of 
industrial hygiene and safety in Bolivian industry; (2) the establish-' 
ment of an employment service; (3) the establishment of a labor 
statistics system; (4) the development of a labor inspection service; 
and (5) the organization of an actuarial service. These were the same' 
objectives as those defined by the joint Bolivian-United States Labor‘ 
Commission (Magruder Commission), which had made the determining' 
studies. The only recommendation omitted was that a study of living 
conditions in the mine regions be made. This responsibility was separ¬ 
ately assigned to a field party ()p<‘rating under the regulai* health aiul 
sanitation program. 

In accordance with the i)lans for carrying out this labor program, 
the Institute of Inter-American Affairs had employed several special- 


2 




ists. 1 hese included a labor economist, an industrial hygiene engineer, 
a safety engineer, and a labor statistician. In the brief period of a 
year and a half, this small nucleus of specialists, with the help of 
Holivian technicians whom they trained, has made an excellent start in 
the development of a program to improve the health and safety of 
Holivian workers. 

Among some of the accom]dishments of this small group, the follow¬ 
ing may be listed: (1) The recruitment and training of ])ersonnel. 
Several Holivians were trained in the Hnited States in industrial 
hygiene and safety and allied fields. These were a physician, an indus- 
tr al hygiene engineer, a safety engineer, a labor inspector, and a labor 
statistician. (2) Various mines and factories have been surveyed by 
th(‘ Institute of Inter-American Affairs’ field jiarty. The total popula¬ 
tion in those industries which have been visited to date is slightly more 
than 30,000. As a result of some of these surveys, some recommenda¬ 
tions for the improvement of health and safety conditions have already 
been made. (3) An industrial hygiene dust laboratory has been estab¬ 
lished and personnel has been trained in the techniipie of sanijiling and 
determining dust. Some of these trainees have been enijiloyed by 
I mining establishments. (4) Various factory inspection forms have 
' been developed. (5) ^Manuals on industrial hygiene and safety have been 
i developed>,vprinted, and distributed widely, ((i) Seminars have been 
(held for ’ ])hysicians and engineers on health and safety jiroblems. 
(7) l>olivia’s labor laws have been reviewed and abstracted for the 
use of labor inspectors. (8) An emiiloyment service manual has been 
jirepared. (3) A dictionary of occupational titles for occupations 
common in Hoiivia is in i)rocess of prej)aration. (10) A labor statistical 
service is being organized within the ^Ministry of Labor. 

As tbe labor program approached its final stages, those responsible 
for it deemed it advisable to have an outside person review its j)rogress 
and accom])lishments in the field of industrial hygiene and suggest 
steps which might be taken toward Ihe orgaidzation of a i^ermanent 
program to be cai’ried on by the Holivian Government itself at the 
close of the present cooperative program. At the re(iuest of the Insti¬ 
tute of Inter-American Affairs, the author of this rejiort was assigned 
bv the United States Public Health Service as an industrial hygiene 
consultant to the labor i)rogram. The Holivian report is based on 
observations made by the author during the ])eriod of February 3 to 
April 16, H)47. 


Pern 

Abundant dei)osits of oil, coal, iron, and other metals insure broad 
economic horizons for INmmi. A rapidly expanding manufacturing 
industry likewist* augur> well for the country’s prosperity. The in¬ 
creasing emi)hasis on maniifaeture, however, luus .trained tiu' floodlight 
of inspection on the welfare of the country’s workers. In this changing 


3 





economic order it has become more and more apparent that the full 
utilization of Peru’s capacities is impeded by the low standards of 
living of her people. 

Realizing her problem, Peru, during the last decade, enacted 
progressive social legislation to improve the lot of the worker. Un¬ 
fortunately, much of the legislation, though well conceived, has suffered 
from lack of adequate implementation. Compulsory sickness insurance, 
old age and death benefits, and workmen’s compensation for accidents 
and occupational diseases have been provided by law for some time, 
but Congress did not enact any legislation for the prevention of indus¬ 
trial disease until March 12, 1947. On that date, the Department of 
Industrial Hygiene was created by law in the Ministry of Public 
Health and Social Welfare. 

The enabling legislation authorized the Department to: (1) Carry 
on a medical and engineering control program in industry in order to 
minimize and eliminate occupational diseases; (2) conduct research; 
(3) carry on educational campaigns; and (4) promulgate rules and 
regulations for the control and prevention of industrial health hazards. 
(A copy of the law will be found in the appendix.) 

During the first 2 years of its operation, the work of the Department 
must be confined to six political departments: Lima, Ica, Junin, Pasco, 
Huanuco, and Huancavelica. Later, if the need is indicated, the 
Department may extend its functions to the entire country. 

Financial support for the Department of Industrial Hygiene comes 
from a levy of 1.8 percent on pay rolls of companies employing morei 
than 30 workers. For the present, contributions come from companies 
“which perform work or make use of mineral substances and soils, 
rocks, clays, sands, gravels, cements, as well as industrial processes ■ 
related to the preparation and use of the above substances.” 

Soon after the law was enacted, the Minister of Health and Social 
Welfare invited the author to come to Peru to assist him in studying 
the industrial hygiene problems of the country and in organizing the 
new Department of Industrial Hygiene. On June 16, 1947, under the 
auspices of the Division of Health and Sanitation of the Institute of 
Inter-American Affairs, the author arrived in Lima where he worked 
jointly with the Ministry of Health and Social Welfare, and the 
Servicio Cooperative Inter-Americano de Salud Publica. The Peruvian 
report is based on observations made by the author during the period 
June 17 to August 29, 1947. 

Chile 

Chile enjoys world prominence in natural deposits of sodium nitrate 
and ranks second in copper production. The war, however, has caused 
Chile to look to new manufacturing vistas. This development of manu¬ 
facturing enterprises was necessitated both to satisfy home consump¬ 
tion needs and to take up the slack in the nitrate market which was 


4 






caused by the production of synthetic nitrates. Chile has also launched 
steel production to help build a more widely industrialized economy, 
and at the same time she is directing parallel efforts at building up the 
health of her workers. 

An invitation was extended to the author early in September 1947 
by the Ministry of Health to study industrial hygiene problems in 
Chile and to devise methods of strengthening existing industrial 
hygiene services. The desired study was conducted under the auspices 
of the Division of Health and Sanitation of the Institute of Inter- 
American Affairs from September 22 to November 10, 1947. 


CONTENT OF KEPOKTS 

The reports of Bolivia, Peru, and Chile contain information on 
potential health hazards in industry and on methods currently em¬ 
ployed to deal with such hazards and set forth recommendations for 
the improvement of industrial hygiene practices. They discuss existing 
legislation bearing on industrial hygiene, the functions of agencies 
concerned with the practice of industrial hygiene, and recommenda¬ 
tions for the strengthening and coordination of such services. For the 
sake of brevity, other pertinent information essential to the adminis¬ 
tration of an industrial hygiene program is omitted from these reports. 
Such information has been presented separately to those responsible 
for industrial hygiene in the three countries under study. It includes 
rules and regulations for the control of occupational diseases; a manual 
of good practice, which in essence is an interpretation of the rules; a 
set of qualifications for industrial hygiene personnel; and, finally, a 
'list of field and laboratory equipment necessary for the conduct of 
industrial hygiene. 

' In short, an attempt has been made to define the industrial hygiene 
problems in Bolivia, Peru, and Chile and to present a definite program 
for their solution. 


5 


11. Method of Study 

Several methods may be employed in defining the industrial health 
problems of a locality. The nature and prevalence of industrial health 
hazards may be established either by detailed studies of workers' 
health and job environments, or by an analysis of occupational mor¬ 
bidity and mortality statistics. In order to define the problem by the first 
method, it is necessary to make extensive studies of the health of the 
workers and the working environments in various industries. This is an 
undertaking of no small magnitude, requiring the services of a staff of 
specialists in the various phases of industrial hygiene. The second 
method is possible only if accurate statistics on occupational morbidityii 
and mortality are available. Since conditions in Bolivia and Peru pre-[ 
eluded the use of either method and insufficient data were availablei 
in Chile, it was decided to determine the nature and extent of indus¬ 
trial hygiene problems by finding out the number and types of indus¬ 
tries in each countiy, the number of persons employed in them, and 
the health hazards to which these workers are exposed. 

Accordingly, a survey of a small number of representative mines 
and manufacturing establishments was conducted, during which special 
survey forms were used to record observations. In brief, the survey 
attempted to obtain information on operations and health hazards in 
the representative working establishments chosen and the control 
methods in use. Information was also obtained on other existing facili¬ 
ties for coping with these health hazards, such as medical services, 
safety and hygiene services, plant sanitation, and feeding facilities. 
Data were also obtained on labor turnover, housing conditions, schools, 
markets, recreation facilities, and community sanitation. Available 
records on occupational diseases were also obtained. (See appendix I 
for forms used.) 

In Peru it was apparent that those responsible for the enactment 
of the present industrial hygiene law had long been aware of the 
serious health hazards which exist in industry. However, there was no 
one source of information wliich presented a well-rounded picture of 
these hazards. Scattered information obtained from individual studies 
of silicosis, lead poisoning, industrial physiology at high altitudes, and 
other investigations indicated an extremely high incidence of occupa- 


6 




tional tliseases among workers—especially among mine workers. There¬ 
fore, hefore the over-all ])rol)h*m eouhl he defined and a solution 
(devised, it was neei'ssary to obtain first-hand information. 

In Chile there has been industrial hygiene activity for some 15 years. 
The Industrial Hygiene Division of the National Department of Health 
I has made some surveys of potential health problems in a few of the 
j nation’s industrial centers. These, of course, were available to the 
author. Finally, toward the close of the study, two conferences were 
held with key representatives of industry and government. The major 
t findings of the survey were discussed and a si)ecific program of indus¬ 
trial hygiene for Chile i)resented for consideration. These conferences 
were sponsored jointly by the ^Manufacturing Society of Chile and 
the School of Public Health. 

In Bolivia the regions where the study was made were the manu¬ 
facturing areas around La Paz and Cochabamba and the tin mines 
! around Oruro and lT)tosi. 

In Peru the survey was made ])rimarily in four regions of the 
country: the nuning region of the central Andes; the mining region of 
southern Peru; the iniiung and i)etroleum area in the North; and the 
industrial area in Lima and its environs. 

In Chile the survey was conducted in three regions of the country : 
the industrial section around Santiago; the coal mining and manufac¬ 
turing region adjoining Concepcion; and the northern region around 
Antofagasta. Throughout the studies, the author received the whole¬ 
hearted cooperation of industry and government, both of which placed 
all of their facilities and records at his disposal. 


7 


III. General Information 


Vicissitudes of living call for the dissociation of man into a number 
of functional units. For a certain number of hours a day, he is known 
as a worker. The rest of the time he is a citizen—taking an interest in 
his family and community affairs, seeking relaxation, undertaking' 
other types of aetivity. In stepping from one role to another, however, 
man does not undergo a change, lie remains the same, subject to all 
the limitations and suseeptibilities that are the lot of human beings.i 
Clearly then, the health of workers cannot be considered in terms of 
the working environment alone. All factors that influence them as: 
total personalities must be brought to bear in seeking to obtain a com¬ 
plete, meaningful picture. Full consideration must be given all these 
stimuli in the formulation of a sound, effective industrial hygiene pro¬ 
gram. For that reason, attention Avas also paid in this report to the 
economic resources of the countries studied, socioeconomic conditions,' 
educational opportunities, and other related factors. An attempt was 
made to touch upon all the elements that enter into a complete evalua¬ 
tion of industrial hygiene problems. 

ECONOMIC RESOURCES 

Bolivia 

Although Bolivia has remarkable economic possibilities in agricul-' 
ture, petroleum, and other raAv materials, mining has been its principal! 
industry for many centuries. The economy of the country is closely' 
linked to mining, to tin mining in particular. Tin is Bolivia’s largest! 
export and its most important source of revenue. 

Peru 

i! 

Peru’s natural resources are many and its opportunities for economic] 
betterment are great. Although Peru is primarily an agricultural || 
nation, its manufacturing industry is growing rapidly, and it is ex-! 
tremely rich in mineral resources. Until recently, Peru’s topography 
has retarded the development of some of these resources. But in the 


8 






j past few years a number of good roads have been constructed which 
connect the tliree important sections of the country and make good 
transportation and communication services possible on a national scale. 

I 

I 



Aviation is also j)laying an increasingly large role in the communica¬ 
tion field. 

Peru has been a storehouse of minerals ever since colonial days and 
is still an im})ortant source of oil and metals. Its coal mines, which 
have recently been (levelo])C(l, will satisfy at least its domestic needs 
for a long time. Iron (lcj)osits which are now being opened will make 
it possible for Peru to have steel, especially when the hydro-electric 
projects are completed in the Chimbote area. 

Chile 

Chile’s mineral resources, especially its copper and nitrates, figure 
prominently in its international trade. Chile is the second copper 
producing nation in the world and is the only country which has 


9 







I 


sodium nitrate deposits of great comiiRu-cial value. Pi*ioi* to tlie war, i 
minerals made u]) nearly (SO ])(‘rcent of the total value of tin; country’s^ 
ex})orts. However, the slump in the nitrate market eaused hy the ])i‘o- 
duction of synthetie nitrates and the war-induced need for ])ro(lucing 
manufactured goods for home consumption have forced Chile to de¬ 
velop manufacturing industries. 



RESOURCES 
OF PERU 


PICTOGRAPH CORPORATION 


10 

















CO«PO»ATION 


With regard to natural resources, Chile may he roughly divided 
into three zones: the northern desert zone which contains important 
copper, niti'ate, and iodine dei)osits, and other mineral mines; the 
central zone which includes the ('ountry’s largest cities and is an 
agricultural and industrial nrea; and the southern zone which is the 
forest and pasture land of the country. 

In the southern zone ;ire also located cohI mines, which are the 
largest in Latin America, and iron-ore deposits, which are being ex- 
j)loited increasingly every yeni*. These coal mines and iron-ore deposits 
make the area a natural center for the i)roduction of steel. At the 
present time a steel mill is under construction just outside of Con¬ 
cepcion. Th(‘ production of steel should assist the country materially 
in develoi)ing manufactui-ing iTidustries. 


rOIHlI ATION 

liolivia, with an area approxiimitely the size of the States of Texas 
and (hilifornia, has an estimated i)oj)ulation of ILTothOOO. Of this 
ninnher, about aOO.OOO aiv city dwellers and another oOO.OOO occupy 

SISjUS—15>—‘J 































the unexplored lowlands. The remainder of the population lives in 
rural areas of the altiplano and is predominantly Indian in race. 
According to the latest data on Bolivia, about 13 percent of the popu¬ 
lation is white and principally of Spanish descent, about 27 percent 
is of mixed Spanish and Indian blood, about 53 percent is Indian, and 
the remaining seven percent is unclassified and includes a small 
number of Negroes. 

Peru is the third largest country on the South America continent 
and is approximately the size of Texas, New Mexico, and Arizona 
combined. It has an estimated population of 7,853,953. Nearly three- 
fourths of this population lives in the Sierra region, which comprises 
about one-third of the total area of the country. The racial distribution 
of the population is about 57 percent, Indian; 25 percent. Mestizo; 
14 percent, white; two percent, Negro; and two percent, Asiatic, 
chiefly Japanese. When it comes to language spoken, however, the 
picture is somewhat different. Forty-seven percent speak Spanish only; 
35 per cent, one of the Indian tongues (Quechua or Aymara) ; and the 
rest speak a mixture of Spanish and other languages. 

Chile is slightly smaller than the West Coast States of California, 
Oregon, and Washington combined. In 1946, the estimated population 
of Chile was 5,702,000. More than half the population is concentrated 
in the central region, and about a fourth lives in the Santiago province. 
The people are distributed almost equally between urban and rural 
areas of the country. 

Chile is predominantly European in its racial make-up; its people 
trace their ancestry back to practically every country on the continent. 
Fewer than one percent of the population are full-blooded Indians. 

INCOME 

Living standards are in direct ratio to the purchasing power of any 
locality. The meager purchasing power generated by low wage scales 
makes for low standards of living in Bolivia, Peru, and Chile. 

The average wages of a factory worker in Bolivia range from 14 
to 20 Bolivianos a day. A miner makes approximately 38 Bolivianos a 
day.^ 

The wages of a mine worker in Peru range from a minimum of 4 to 
a maximum of 10 soles per day and average about 6.50 soles a day. In 
most factories wages are somewhat higher, starting with a minimum of 
2.50 soles for beginners and going as high as 14 soles a day in some 
of the large factories in Lima. Average pay is about 8 soles per day. 

In the Chilean factories visited during this study, average wages 
ranged from a minimum of 20 and 28 pesos a day for women and men, 
respectively, to a maximum of 95 pesos a day, the average being some¬ 
where around 75 pesos. However, the factories visited by the author 

1 Currency equivalents as of May 1948: $1, 42.0 Bolivanos; .$1, 6.5 soles; $1, 31.1 pesos. 

12 



were located in urban centers where wages are known to be higher 
tlian elsewhere in the country. According to statistics of the Workers’ 
( ompulsory Insurance Fund, which lias fairly accurate data on this 
subject, the average wage of a factory worker in Fhile is :U) ))esos a 
day. The wages of miners range from oO to 90 ])esos a day. 

On the whole, miners in the tliree countries are better oT than fac¬ 
tory workers, in that they have emi)loyer-i)rovided ‘'benefits.” Free 
or low-cost housing, free medical care and hospitalization for mine 
workers and their families, and primary schools for their children are 
provided by the larger companies. ^Miners also have the opimrtunity to 
buy from company stores, or pulperias, which sell goods at cost or at a 
slight loss. 

In one large company store in Peru, for exainjile, the j^rices of some 
eight essential food items were at least 20 percent lower than in other 
stores in the community. This ])ractice creates a problem since em¬ 
ployees resell goods they buy to obtain extra funds. When company 
stores run out of goods, i)rivate stores raise jirices for goods in short 
supply. Table 1 shows prices charged by in-ivate stores and a company 
store in one mining area in Peru. 


Table 1 .—Comparison of prices between a company managed store and private stores in Peru 


Item 


Prices in soles 


Company managed 


Private 


Spaghetti per kilo_ 

Pork per kilo_ 

Shoes per pair_ 

Sugar per kilo_ 

Cloth materials per metre 

Meat per kilo_ 

Oats per kilo_ 

Bread: 

Per 84 grms_ 

Per 40 grms- 


1.00 
5.20 
27.80 
0.32 
1.60 
1.00 
1.60 

0.05 


1.80 

8.00 

39.00 

0.40 

3.50 

2.20 

2.20 


0.05 


Most companies claim that they lose a day’s pa}’ on every worker in 
the pulperia. On the other hand, rather than raise wages so that the 
miner may purchase his goods wherever he wishes, the mining com¬ 
panies prefer the pulperia system for many reasons, even though the 
pulperia has been outlawed in some countries. Perhajis one of the 
most important reasons for not abandoning the pulperia lies in the 
fact that workmen’s compensation and other social security benefits 
are based on the miner’s actual wages, and do not take into considera¬ 
tion wages in kind, such as accrue to the worker from the chea}) jm!- 
peria and other employer-provided “benefits.” 

Despite the cheap food, housing facilities, free iirimary scliools, and 




















recreational facilities furnished by the larger companies, the prevail¬ 
ing low wages in Itolivia, Pern, and Chile do not proAdde sufficient 
funds for a decent standard of living. 

The rampant inflation which these countries have experienced has 
made the lot of the wage earner even more difficult. Many of the bare 
necessities of life, such as clothing, are so expensive that they con¬ 
stitute a luxury to the average mine and factory worker. The same is 
true of many basic food supplies. 

The food problem is further complicated in Bolivia because that 
country is largely dependent on foreign, and sometimes distant, pro¬ 
duction. There have been shortages recently of sugar, wheat, meat, 
rice, flour, and other staples, especially in the mining centers and in 
some of the large cities of the altiplano. Frequently, crop failure in 
other countries and breakdowns in Bolivia’s poor transportation system 
halt the steady flow of food into the country. 

Chilean studies, too, bear out the disproportionately high cost of 
food. It is estimated that the amount of income spent for this neces¬ 
sity ranges anywhere from 33 to 75 percent. As a result of the high 
cost of foodstuffs, 50 percent of the Avorkers and their families suffer 
from malnutrition. In fact, recent investigations in the coal mining 
areas of Chile indicate that coal miners have a daily diet deflciency of 
1,600 calories. This lack must certainly play an important role in the 
high incidence of many communicable diseases among this group of 
workers. 


HOUSING AND LIVING CONDITIONS 

Housing in Bolivia, Peru, and Chile is in acutely short supply. Even 
in Chile, where management-furnished housing is an improvement over 
that of some of the other South American countries, most dwellings, 
especially in the mining communities, are drab, overcrowded, and in¬ 
sanitary. They frequently lack even the mo‘st elementary sanitary 
facilities. Such conditions are also true of some of the large cities in 
these countries. Information obtained from a survey of establishments 
in Peru typifies the prevailing situation in all three countries under 
study. Detailed data on community facilities available to these Avorkers 
are presented in table 2. 

Many of the miners’ homes are of the adobe type or built out of 
cinder blocks. Usually, houses are constructed in a series of 20 or 
more to a unit or block. The houses- vary from one room to as many 
as three and sometimes four rooms. The latter, however, are usually 
reserved for Avhite collar Avorkers, or empleados, and a nominal charge 
is made for them. At one large establishment in Peru two-room houses 
rented for 3.75 soles a month; three-room houses, for 7.50; and the 
four-room variety, for 12.50. 


14 


Housing conditions Community stores 



If) 


' Refers to common areas for baths, toilets, anJ laundry facilities. 
^ ('ornpany controls prices. 

* f'lcan. 


















































































































Nearly three out of four houses in many of the camps are of the 
one-room variety. As a consequence, crowding is a critical problem. 
It is not uncommon to find four to eight persons living in one room, 
which also serves as a kitchen, dining room, and bedroom. For example, 
in one community where 2,600 workers are employed, there are 1,650 
houses. In another large mining camp employing nearly 3,000 only 
450 houses are available. 

Similar conditions were observed in Chile. Houses around the 
sulfate mines in the northern desert and the coal mines around Con¬ 
cepcion were too few in number and lacking in sanitation besides. 
Dwellings around the larger copper mines were fair on the whole, 
although there were not enough of them. Homes at a sugar refinery 
and in the nitrate fields in the north were perhaps the best found in 
this survey. The photographs which follow clearly show the difference 
between the houses provided. 

In the coal mining area of Chile some 4,000 houses were surveyed. 
Nearly 1,500 were insanitary and 1,600 uninhabitable. Single persons, 
as a rule, shared one-room houses, which were occupied by as many as 
four adults. In one large copper mining concern there were approxi¬ 
mately 1,700 houses for 8,000 persons. The average number of persons 
per room was 3.7, and the average number of persons per bedroom, 5.1. 
The average number of persons per bed was 2.2. Housing conditions 
in these mines were by no means the worst in Chile; dwellings provided 
for Avorkers in the fishing industry were not even as good. 



A worker s dwelling and his family at a coal mining camp 


16 



Worker s model house at a sugar refinery 

As a rule, water is obtained from spigots at each end of a block of 
houses. Toilets, as well as laundry and shower facilities, are usually 
of the communal type. Waste water runs into uncovered troughs in 
outside ditches which are also used for garbage and sewage. As far 
as can be determined, none of the water supplies is approved. 

With the exception of two or three large mining concerns in Chile, 
human waste was permitted to flow untreated into nearby streams or 
into the open desert. In only a few instances are facilities available 
for garbage removal. Carrion and fly-infested garbage litter the backs 
of houses and the streets. 

There is no denying that, by comparison with some of the privately 
owned huts of some of the workers, most company houses are a great 
improvement. In many, but not all, of the larger mining communities, 
animals are not allowed around the houses in the camps. In all the 
privately owned homes, domestic animals have free access to the 
workers’ homes. At present, few miners own their own homes. It is 
understood that most of them would like to own their own homes, so 
that they can have gardens, keep their animals, and gain a sense of 
stability, which they do not have now. 

The problem of labor turnover is influenced to .some extent by this 
lack of stability. It is felt that industrial establishments should en¬ 
courage workers to have their own homes and assist as much as possible 
toward the achievement of this objective. The excuse which many 


17 



firms now give for failing to encourage liome ownership is that the 
workers would abuse it. This is not a valid excuse, since a company’s 
responsibility, as well as that of the Government itself, should not end 
with the provision of the means and the opportunity for owning a 
home. It should go beyond that and include an educational program 
to teach the workers how to live in a sanitary and healthful fashion. 

Most of the larger concerns are fully aware of the housing problem 
and are attempting to build additional housing. Unfortunately, with 
the single exception of one large petroleum company in Peru which 
has an ambitious modern housing program, the companies are making 
d:he same mistakes in their new housing projects that they did in their 
old ones. Many of the townsites are selected with no regard for health 
and sanitation requirements, and the houses still lack elementary sani¬ 
tary facilities. The workers’ houses being built by the petroleum com¬ 
pany are an exception to the rule. They are models in construction and 
sanitation and should be conducive to good health and well-being. 

In 1936, Chile established the Popular Housing Fund for the con¬ 
struction of low-cost houses. The Fund has improved the situation 
somewhat, but its program has been inadequate for the needs of the 
country. It is estimated that about 300,000 homes are needed to 
alleviate the present congestion. At the cirrrent rate of construction, 
10 years will elapse before that many houses can be built. 

In summary, therefore, it may be said that housing and living con¬ 
ditions in industrial communities in these three countries, especially 



U orkers’ houses at a smeller 


18 




in the mining areas, are inadequate in quality and insufficient in quan¬ 
tity. A vigorous housing program on the part of the Government and 
the industries concerned is needed. Concurrently with such a program, 
workers and their families should get the benefit of a vigorous educa¬ 
tional program on healthful living. With perhaps one or two excep¬ 
tions, neither the Government nor industry has conducted such cam¬ 
paigns. Living conditions as they exist now are potential sources of 
ill health and no doubt are factors contributing to the social unrest 
and labor strife prevalent in Bolivia, Peru, and Chile. 


EDUCATION 

Closely related to poor health, poor housing, and low wages, are 
such social problems as illiteracy. It has been estimated that in Bolivia 
80 percent of the population is illiterate and that not over one-sixth 
of the school age children are enrolled in schools. 

Many children under 14 j^ears of age are employed in mines and 
factories Child labor not only deprives these youngsters of the educa¬ 
tional opportunities they should have, but definitely imperils their 
health and future productiveness. 

Perhaps the greatest educational problem in Peru is the incorpora¬ 
tion of the Indian into the nation’s life and society. Native Indian 
languages are si)oken by a great majority of the peoi)le. Indian cul¬ 
ture and tradition affect every aspect of Peruvian life, including 
industry. 

According to the 1940 census, only 42 percent of the population was 
literate. The rate of literacy varied from approximately 93 percent 
in Callao to only 12.6 percent in Apurimac. In the Sierra, where most 
of the mining communities are located, the percentage of literacy was 
lowest, because of the large Indian i) 0 ])ulation there and the lack of 
adequate educational facilities. According to law, mining companies 
in who.se communities more than 30 children live are required to main¬ 
tain schools. The company is required to build and maintain the school 
building and pay the salaries of the teachers who are appointed by the 
Government. The equivalent of at lea.st the first four grades must be 
taught in these .schools. Special literacy schools are also supposed to 
be })rovided for adults whenever 20 persons make known their wish 
to study. 

Most of the .schools visited in both Bolivia and Peru were over¬ 
crowded and lacked the most elementary materials and equipment. A 
few of these schools did not go beyond the second grade of in.struetion. 
X'iirious studies reveal that j)rimary education, sueli as it i.s, is nvail- 
al)le to only a small fraction of the j)opulation. As already mentioned, 
many .schools lack rudimentary facilities such as cimirs, desks, books, 
blackboards, and chalk. .Many of those visited lack i)roper sanitary 


19 


facilities and, with but one or two exceptions, fresh air is shunned in: 
most of the schools—the windows are hermetically sealed. Obviously, 
the lack of ventilation and the unhygienic state of the pupils are not 
conducive to either good health or comfort. Furthermore, the ex-:: 
tremely low salaries paid to teachers do not attract qualified persons ' 
to the profession. 

Hygiene is generally unknown to the Indians, so that health educa¬ 
tion is a major and urgent necessity. In Bolivia no effort was made to 
teach it in the schools before the initiation of the cooperative programs 
of the Inter-American Educational Foundation and the Institute of 
Inter-American Affairs. However, it is impossible to bring such educa¬ 
tion to large groups of people who cannot read and who do not even 
speak the same language as the teachers. 

In comparison with other South American nations, Chile is making 
great progress in the field of public education. More than 70 percent 
of its people are literate and the number of persons receiving higher 
education is steadily increasing. Table 3 shows the extent of school 
attendance in Chile as revealed by the 1940 census. It may be seen 
from this table that nearly 60 percent of the population 7 years of 
age or older receive primary instruction. This is all the education that 
the vast majority of the population receives, for only about ten percent 


Table 3 .—Educational status of persons 7 years old and over, in Chile 


Degree of instruction 

Number 

Percent 

Total 

Male 

Female 

Total 

Male 

Female 

Primary_ 

2,376,065 

1,190,160 

1,185,905 

58.8 

59.7 

58.0 

Secondary-- 

390,884 

191,788 

199,096 

9.7 

9.6 

9.7 

University .. — . __ 

50,087 

35,042 

15,045 

1.2 

1.8 

0.7 

Technical-— -- 

44,223 

25,604 

18,619 

1.1 

1 3 

0.9 

Cannot read_ __ 

1,177,699 

549,652 

628,047 

29.2 

27.6 

.30.7 

Total-- - 

4,038,958 

1,992,246 

2,046,712 

100.0 

100.0 

100.0 

No data available_ 

113,231 

56,384 

56,847 












go on to high school. About one percent receives university training; 
and another one percent, training of a technical character. Many other 
countries in South America send students to universities in Chile. | 
Most of the Chilean schools visited during the survey were fairly i 
adequate and were maintained in a sanitary condition. 

In general, the lack of adequate school facilities and instruction all 
operate against building a strong and healthy race. Education plays 
an important role in determining the health and productivity of the i 
working population. 


20 
























COMMUNITY HEALTH AND SANITATION 


Bolivia 

According to studies made by personnel of the Institute of Inter- 
American Affairs and studies of medical and sanitary conditions made 
by the United States Army, general health conditions in Bolivia are 
very unsatisfactory. 

^lalaria, tuberculosis, venereal diseases, leprosy, epidemic typhus, 
intestinal parasites, smallpox, typhoid fever, yellow fever, and bubonic 
plague are common throughout Bolivia. Malaria is prevalent in over 
80 percent of the country. Epidemic louse-borne typhus is common 
throughout the highlands. Official reports state that 98 to 100 percent 
of the population has helminthiasis. Infant mortality is known to be 
much higher than the reported 110 per 1,000 live births. Disease con¬ 
trol is made especially difficult by the diversity of races, the hetero¬ 
geneity of customs, lack of transportation and means of communica¬ 
tion, and low standards of living. 

The development of Bolivia’s rich natural resources is largely in¬ 
hibited by disease, control of which is in turn limited by lack of funds 
and trained personnel. In 1944, Bolivia appropriated about $1,041,742 
(U.S.) for public health, less than 30 cents per capita for the estimated 
population of about 3,750,000. By comparison, the United States 
budgets more than $2 per capita for State health work. 

In 1945, there were 72 hospitals in Bolivia, with a total of 4,229 
beds, the ratio of beds per 1,000 inhabitants ranging from 0.6 in the 
Department of Santa Cruz to 2.7 in the Department of Beni. In 1946, 
there were 569 physicians in the entire country (one for every 6,000 
persons), nearly half of whom were concentrated in La Paz. Well- 
trained nurses and technicians are also scarce, so that thousands of 
Bolivians are not able to secure even the .simplest medical attention. 
[According to a survey made iiy the United States Army ^Medical Corps 
it was found that over 60 percent of the people in Bolivia do not have 
medical attention during their final illne.ss. 

' There is not a single safe water system under proper control in the 
I entire country and there are, as a result, recurrent outbreaks of 
typhoid fever all over the country. Several of the larger towns have 
.sewers, but there are no sewage treatment facilities. 

Bern 

j As in P>olivia, lack of funds and trained personnel militates against 
the control of disea.se in Pern. The rural areas esjieeially suffer from 
the .scarcity of doctors, nurses and hospitals. Most of the trained pro- 
fe.ssional workers and facilities are located in Lima. In 1947, Peru 
appropriated approximately $4,8()(),()()() (U.S.) for public health, or 
about 60 cents per capita. 


21 



There are only about two safe water systems in the entire country, 
and it is only within the last year that the Ministry of Public Health 
and Social Welfare has been given responsibility for the administration 
of water supply. This function will be carried out by the Department 
of Sanitary Engineering, which, at the moment, has only seven trained 
sanitary engineers. 

Sewage treatment is practically unheard of in Peru. Several of the 
hirge cities have sewers, but no treatment facilities. Incidence of 
tuberculosis is known to be high in Peru and is one of the major com¬ 
municable disease problems of the country. Although rates are not 
available for most of the communicable diseases, some idea of the 
health problems of the country may be gleaned from the experience of 
1946. In that year, 123,490 cases of infectious diseases were reported 
to the IMinistry of Health. Of these, 57,883 were malaria; 18,671, 
tuberculosis; 12,295, whooping cough; and 6,931, dysentery. Mortality 
I'rom tuberculosis averages about ten times as high as in the United 
States. It is well known that the reporting of communicable diseases in 
I^eru is inadequate, and undoubtedly these data are an underestimate. 

Proportional mortality is available for 1945. These data show that 
of all deaths reported, tuberculosis accounted for 6.2 percent; pneu¬ 
monia, 1.4 percent; grippe, 8.1 percent; and other respiratory diseases, 
12.9 percent. In other words, respiratory diseases accounted for 28.6 
percent of all deaths in Peru during 1945. 

The administration of public health in Peru is largely a centralized 
t'unction of the Ministry of Health and Social Welfare. With the ex¬ 
ception of the work going on in cooperation with the Institute of Inter- 
American Affairs in a few restricted areas, departmental, provincial, or 
local public health work is an unheard of phenomenon in Peru. Al¬ 
though mining companies are obliged by law to provide camps, schools, 
and sanitation services, such as water and sewage disposal, there has not 
been adequate governmental supervision and administration of com¬ 
munity sanitation. Leadership has been lacking, too, in assisting indus¬ 
try to improve public health conditions in industrial areas. 

Chile 

Many agencies concern themselves with health and welfare in Chile. 
The majority of these, however, are interested in curative medicine. 
Preventive medical care is left largely in the hands of the Department 
of Health. 

The administration of public health in Chile, as in most Latin Ameri¬ 
can countries, is centralized under the Director General of Health 
whose headquarters are in Santiago. Branch offices are located in the 
various provinces, which for administrative purposes are groui)ed to¬ 
gether into zones. AVith the exception of one or two provinces, public 
health work is in the hands of part-time professional ])ersonnel, most 
of whom have not had formal public health training. This deficiency. 


22 




is slowly bein^ overcome tlirongli traiiiinj' programs for public health 
workers given l)y the recently organized School of Public Health. Chile 
is slowly l)nil(ling nj) a nucleus of trained public health workers, but 
many years will elapse before a sufficient number are trained. 

Another drawback to the exi)ansion of i)ublic health programs has 
been lack of funds. At the i)resent time, the budget for public health 
in Chile is ai)proximately 25 pesos, or roughly, 75 cents (U.S.) per 
capita per year at the official rate of exchange. 

It is well known that there is a scarcity of physicians, nurses, and 
hospitals in Chile. There are ai)proximately 2,()()() physicians, or rough¬ 
ly one for every 2,500 i)ersons. Thisdistribution is better than in some 
South American countries, but it is not good. The shortage of pro¬ 
fessional health personnel is more acute in rural areas since physicians 
and nurses tend to congregate in the larger urban centers where re¬ 
muneration is greater. 

The general mortality rate in Chile is roughly double that of the 
United States. Although infant mortality is decreasing, it is still high, 
the average rate registered for the period 1041-45 being 170. The con¬ 
trol of communicable diseases, especialh' tuberculosis, is still a major 
and serious problem. Tyj)hoid is quite prevalent. Hookworm is ei)idemic 
in some areas, notably in the coal mining section of the country. In 
some of the coal mines studied recently about 05 percent of the workers 


were found to be infested with the hookworm parasite. 

Tuberculosis merits special discussion since it is probably Chile’s 
outstanding health ])roblem. Although the death rate from this disease 
recorded for 1940 is approximately 208 per hundred thousand, in many 
.sections of the country the rate is much higher. In the city of Concep¬ 
cion, the deatli rate in 1945 was slightly more than twice that registered 
for the country as a whole. 

The tuberculosis problem is aggravated by the scarcity of hospital 
beds and by overcrowded housing, which make it impossible to isolate 
I patients in their homes. 

General commuinty sanitation in Chile also leaves much to be desired. 
Only 25 percent of the i)eople in all of Chile are served by water supply 
systems and an e(pial number are ])rovided with sewerage facilities. 
With the exception of Santiago, only 85 percent of the urban popula¬ 
tion have approved drinking water while 65 percent have public sewer¬ 
age facilities. There are 64 cities of more than 1,000 and le.ss than 5,000 
inhabitants which have no drinking water facilities and 155 cities which 
have no public sewerage. At present, through a cooperative program 
conducted by the In.stitnte of Inter-American Affairs and the IMinistry 
of Health, (piite a lot is being done to improve the sanitary environ¬ 
ment. This cooperative program is also improving the general health 
j)icture by constructing health centers in some districts. The work car¬ 
ried on in this joint program will be touched on later in this report. 


23 



This brief summary of public health problems in Chile indicates that 
progress is being made toward their solution. The problems are so| 
large, however, that it will take many years of vigorous, sustained effort j 
on the part of the Government, the people, industry, and labor itself, jj 
to raise the health level of the labor force. Unless this is done, however,] 
Chile’s plan to develop its resources and to raise its living standards| 
will be seriously frustrated. | 


SUMMARY 


The brief foregoing sketch of the background of the industrial popu*j 
lations of Bolivia, Peru, and Chile points up that niggardly wage! 
scales, congested and unhygienic living conditions, and primitive sani-^ 


tation predispose these countries to disease. Sickness rates—both gen¬ 


eral and occupational—are high. The pall of illiteracy in Bolivia and 
Peru further fosters these conditions and makes remedial education 
difficult. A comprehensive educational program in hygienic living 
should be attempted, however, despite these limitations. To improve’ 
facilities without accompanying sanitary instruction is to build on^ 
quicksand. Even the finest structure will soon crumble without proper, 
maintenance. Against these socioeconomic needs, the added health; 
problems which have their origin in the working environment must be ■ 
studied and solved. 


24 



IV. Health in Industry 

Since a worker’s health is determined to a large degree by the re¬ 
sponse to both nonoccupational and occupational stimuli, a considera¬ 
tion of both sets of factors is necessary for a complete study. The socio¬ 
economic conditions highlighted in the foregoing section reflect non¬ 
occupational influences. Attention is now concentrated on the health 
problems that are directly related to the working environment. 

In the course of these studies, health and safety problems inherent in 
industrial working environments were assessed in several ways. Al¬ 
though it was impossible to make detailed studies of the health of the 
workers or of working conditions, sufficient information was obtained 
about working environments and industrial health services provided in 
plants to get a good idea of occupational hazards and measures taken 
to correct them. 

The present studies, although limited to a visual survey of the work¬ 
ing environments in representative industries and a study of statistics 
available in the various government agencies concerned with industrial 
hygiene, do present a fairly comprehensive review of occupational 
hazards and the measures now in force to correct them. 

GAINFULLY EMPLOYED 

[ Bolivia 

I Although no accurate data are available on the size of the labor force 
in Bolivia, it is estimated from data furnished by the Caja de Seguro 
! and the Chamber of Commerce that there are approximately 100,000 
persons employed in the country’s mines, factories, and service indus¬ 
tries. Of this number, approximately 40,000 are employed in the mines. 

Not even an estimate of the number of workers engaged in agricul¬ 
tural pursuits is available. It is known, however, that large numbers 
of agricultural workers, employed by owners of rubber and coffee 
plantations, live and work in isolated communities in the tropics. 

Peru 

The latest information on the size of the labor force in Peru is that 
based on the rather extensive 1940 census. At that time the number of 


25 




gainfully employed persons totaled 2,475,339, of which nearly 1,600,000 
were males. It nmy he seen from table 4 that about 50 percent of the 
gainfully emj)loye(l wei’e found in agriculture. iManufacturing account¬ 
ed for 3H0,()()() jxu'sons and mining for m^arly 45,000. 

Due to the fact that most manufacturing industries produce light 
consumer goods for domestic use, a larger proportion of female workers 
is found in these establishments. Of the 380,000 persons in manufac¬ 
turing, approximately 215,000 or 56 percent are women. The most 
important manufacturing industry in Peru is the textile industrj^ The 
manufacture of clothing and its accessories is second. 


Table 4 .—Labor force by major industry group in Bolivia, Peru, and Chile 


Industry group 


BOLIVIA (data not available) 

Total labor force_ 

Mining industries (estimated)_ 

Manufacturing and service industries (estimated)_ 

PERU (1940 census) 

Total labor force_ 

Agriculture_ 

Cattle raising, forestry, fishing, and hunting_ 

Mining and similar industries_ 

Manufacturing-- 

Building, construction, and repair- 

Transportation and communication_ 

Commerce, credit, and insurance_ 

Public administration and other services of general interest- 
individual professions, domestic and other personal services 
Other economic fields not classified- 

CHILE (1940 census) 

Total labor force_ 

Agriculture and fishing_ 

Mining_ 

Construction_ 

Manufacturing_ 

Trade_ 

Transportation, communication, and public utilities_ 

Finance and insurance_ 

Domestic service_ 

Government service_ 

Miscellaneous industries_ 

Unemployed_ 


Number of persons 

Total 

Male 

Female 

(?) 

(?) 

(?) 

40,000 

(?) 

(?) 

60,000 

(?) 

(?) 

2,47.'>.339 

1,598,321 

877,018 

1,293,214 

931,468 

361,746 

252,975 

129,008 

123,967 

44,694 

43,463 

1,231 

380,281 

165,516 

214,765 

45,659 

44,782 

877 

51,079 

48,656 

2,423 

112,126 

76,025 

36,101 

89,021 

72,514 

16,507 

165,099 

53,879 

111,220 

41,191 

33,010 

8,181 

1,621,300 

1,325,939 

295,361 

620,489 

580,723 

39,766 

91,220 

89,479 

1,741 

64,559 

63,640 

919 

286,730 

193,463 

93,267 

200,636 

132,414 

68.222 

89,707 

84,468 

5,239 

14,628 

12,487 

2,141 

3,279 

2,844 

435 

115,4.53 

93,656 

21,797 

133,591 

72,196 

61,395 

1,008 

569 

439 


Of the nearly 45,000 persons employed in mines, the largest number, 
i ,000 are in the oil fields, with gold and copper mines coming next. 

It may be seen from these data that more than a third of the popu¬ 
lation of Peru is gainfully employed. Of those employed, slightly more 
than a half million are engaged in industries, such as mining, milling, 
and manufacturing, with which major health hazards are usually 
associated. 

Chile 

Although no current estimate of the number of gainfully employed 
persons in Chile is available, 1940 census data are still accurate enough 


26 






















































to give an approximation cf the total labor force. Tn 1940, out of a 
total population of approximately b.OOtfOOO, nearly one-third were 
gainfully oeenpied. As may be from table 4, slightly more than 

fiOO.OOO, or .48 ])ereent of tlie l.VOO.OOO gainfully em|)loy(*(l persons, 
were engaged in agriculture. .M* . ^-leturiug ranked second with ap¬ 

proximately 290,000 w'orker.s; and mining accounted for slightly more 
than 90,000 persons. Only 300,000 women were in the labor force. 
Industrial w’orkers in Chile constitute as large a group of employed 
persons as those engaged in agricultural pursuits, the two groups ac¬ 
counting for approximately 75 percent of the labor force. The balance 
of the working population includes professional and white-collar workers 
and a small number of people engaged in domestic service. 

To summarize, one-third of the nation’s ])opulation is employed, and 
of this number apjiroximately 1,()()0,()()() work in occnjiations with 
which health hazards are associated. From the standpoint of numbers 
alone, therefore, it is obvious that serious consideration should be di¬ 
rected to the health and safety i)roblems of this group whieli makes up 
some 20 percent of the nation’s human resources. 


INDUSTKIES SUKVEYED 

A rei)resentative group of mining and manufacturing establishments 
in each of the three countries was surveyed to obtain first-hand infornia- 
|tion on health hazards and facilities for coping with them. The specific 
I types of industries surveyed, together with number of establishments 
land workers included, are shown in table 5. In llolivia, dust determina¬ 
tions made previously by the personnel of the labor section indicated 
silica dust exposures in the various establishments. Statistics on occu¬ 
pational diseases and some figures on accidents were obtained from in¬ 
dividual concerns or government agencies. These helped to define the 
1 problem on a (piantitative basis. 

I In general, the information gathered ])ertains to hazards in the work- 
;ing environment and their control; compensation and sickness benefits; 
imedical services, including dentistry and nursing; safety precautions; 
disability records; feeding facilities; and general sanitation, such as 
water supply, sewage dis])osal, toilet facilities, and locker rooms. 

Even though the number of workers and i)lants included in the sur¬ 
vey appears to be small in relation to the total number of workers and 
establishments in each of the three countries, the plants selected wen* 
sufheientiy re|)resentative of industry to allow the drawing of valid 
conclusions. 

liolivia 

In Bolivia, 23 establishments were surveyed, employing a total of 
26,488 workers, or api)roxiniately 25 percent of the estimated popula- 

81S94S—41>—3 


27 







tion in manufacturing and mining industries. Fifteen of these were 
mines and mills, and eight were manufacturing or service industries. 
Thirteen of the mines produced tin, three of them producing some 
tungsten ore as well. All but 3 of the 13 tin mines also operated mills 
for concentrating ore. Of the two remaining mines, one produced! 
antimony and the other copper. The latter also had a mill as part of its 
operations. j 


Table 5 .—Type of industries surveyed iri Bolivia, Peru, and Chile 


Industry group 

Bolivia 

Peru 

Chile 

Estab¬ 

lishments 

Workers 

Estab¬ 

lishments 

Workers 

Estab¬ 

lishments 

Workers 

All establishments surveyed_ 

23 

26,488 

21 

22,935 

21 

46,089 

Mining industries_ 

15 

23,774 

16 

20,530 

8 

34,552 

Mining, milling and/or smelting of: 







Antimony_ 

1 

28 





Coal__ _ 



3 

2,550 

1 

9 200 

Copper_ _ 

1 

786 

1 

650 

3 

12,856 

Gold_ 



1 

450 



Lead, copper, zinc, silver_ 



7 

9,720 



Nitrate__ _ 




2 

10 250 

Sodium sulfate_ 





1 

746 

Tin_ 

13 

22,960 



Vanadium_ ___ 



1 

750 



Oil and gasoline production__ 



1 

5,000 



Hydroelectric construction; tunnel 






construction and mining_ 



2 

1,410 



Repair shops for copper companv-- 




1 

1,500 

Manufacturing industries__ 

8 

2,714 

5 

2,405 

13 

11,537 

Canned fish_ _ 





1 

900 

Sugar, industrial alcohol__ 





1 

606 

Cotton, woolen textile mill products- 

1 

1,000 

1 

984 

2 

2,815 

Shoes; leather_ __ _ _ 

3 

315 





Glass products; china ware; ceramics 

1 

750 

2 

432 

4 

3,201 

Cement; asbestos building material- 

1 

200 

2 

989 



Copper wire__ 





1 

840 

Steel rods; metal products_ 

1 

145 



2 

1 750 

Printing_ 





1 

140 

1 95^^^ 

Gas, coke, tar_ 





1 

Airplane service_ 

1 

304 












The 15 mining establishments employed a total of 23,774 workers, I 
thereby accounting for the bulk of the persons included in this survey. I 
This is not disproportionate, since mining and milling of ore is Bolivia’s 
major industry and the most important one from the standpoint of ! 
economics and health hazards. Nine of the 15 mines and mills em-' 
ployed more than 500 workers, while the remainder employed fewer,' 
two employing under 100 workers each. 

The eight manufacturing and service estaolishments surveyed em-' 
ployed 2,714 workers. They included two shoe factories, a tannery, a 
large cotton textile plant, a glass bottle works, a cement mill (the only 
one in Bolivia), a foundry and machine shop, and an airplane repair 
shop. 

Peru 

The 21 mines and factories visited in Peru employed 22,935 workers. 
Of these 21 plants, five were manufacturing (a glass bottle works, ^ 

28 




































































cement mill, a refractory brick and cliinaware plant, an asbestos and 
ceimnit buildin*; material [)lant, and a woolen mill); Dl were mines, 
inelndinjr a tiinn(‘lin^ job for tin* hydroelectric project, a petroleum 
oj^eration, a hydroelectric construction project, a smelter, and a coal 
washer. All the mines which j)rodiiced metallic ores had concentrators. 
Of the 11 mines actually ])roducin‘^ ore and concentrate, one was a 
‘Told mine; two produced coal; one, vanadium ore; and the balance, a 
mixture of coi)i)er, lead, zinc, and silver. Only 2,405 of the 22,935 
employees surveyed were employed in the manufacturing establish¬ 
ments. 

Chile 

A total of 21 establishments which employ 4(),089 workers Avere cov¬ 
ered in the (diile survey. Eight of these were mining establishments 
j typical of mining operations in Ohile. Included were one coal mine, two 
j nitrate mines, one sodium sulfate mine, and two copper mines and 
1 smelters. The eight mining establishments employed 34,552 workers, or 
! 75 ])ercent of all the workers covered by the survey. 

I The 13 manufacturing plants surveyed employed 11,537 workers of 
I whom about 20 ])ercent were women. Included in the variety of indus¬ 
tries r(‘pi-esented were: a fish cannery, a sugar refinery which also 
I made industrial alcohol, two textile plants, one lithography and print¬ 
ing sho]), two glassware i)lants, one ceramics plant, one ])lant making 
: steel rods, another plant producing coi)])er wire, and another producing 
, stoves and other metal ])roducts. 

OCCl PATIONAL HAZARDS 

Health and safety consciousness was at a low level among manage¬ 
ment and workers in most of the mines, mills, and the manufacturing 
and service industries covered b}' the surveys. Working conditions 
described in this and following sections reflect this apathy. 

In Chile, the author was impressed with the fact that the managers 
;of the manufacturing establishments at least were not deliberately ex¬ 
posing their employees to health and safety hazards but were usually 
doing so unwittingly because of ignorance. A few industrialists felt 
that they made a sufficient contribution to social welfare by i)aying 
I taxes and that anything else necessary should be done by the Govern¬ 
ment. It would be heli)ful if the Government itself would take the 
initiative in ])roviding industrial hygiene and safety services. The fault 
has not been a lack of willingness on the part of the governmental 
agencies charged with this res])onsibility, but mainly a lack of suf¬ 
ficient funds and trained personnel. 

MUSES 

Occupational health hazards in the mines in the three countries under 
observation were similar in many respects. The chief health hazards 


29 


were exposure to silica dust released during drilling, loading, and 
transportation oi:>erations; carbon monoxide in some mine galleries; 
sulfur dioxide in a few mines where ores were sulfide in character, as. 
in Peru; fumes from blasting })owder; and high humidity, particularly |j 
in the lower levels of tlie mines, and other temperature extremes. ^ 

The most serious of these health hazards was the exposure to silica j 
dust which confirmed the high rate of silicosis among Bolivian, Peruvi¬ 
an, and Chilean miners. 

Bolivia 

The ore obtained from Bolivian mines surveyed contained free silica 
varying from 35 to 90 percent. The silica was present as amorphous 
quartz mineral and also as crystalline quartz. Most of the dust was 
produced during drilling, blasting, and waste removal operations. 

Drilling was the mining operation which produced the greatest 
amount of dust. It was usually done with compressed air drills. 

Although drilling was supposed to be done wet to cut down on dust 
hazards, dry methods were frequently used. Even though some miners 
employed wet methods, a single mine crew using dry methods in a sec¬ 
tion could heavily contaminate the air in the entire section. One or two 
of the mines had installed air washers in the main air courses, but these 
only partially reduced the dust contamina.tion. 

Air samples taken by members of the staff of the labor section during 
drilling operations indicated dust exposures varying from approximate¬ 
ly 30 million particles (wet drilling) to 600 million particles per cubic 
foot (dry drilling). 

Blasting operations were carried on during all development and 
stoping activities using 40 to 60 percent gelatin dynamite. During 
stoping operations, blasting was used not only to break the ore from 
the solid body, but also to break up large aggregates of mineral. Blast¬ 
ing produced much dust and, as a rule, took place at the beginning of 
the lunch hour or at the end of a shift. Lunch hour blasting, however, 
did not provide sufficient time for smoke and dust to clear. 

In the mines surveyed, the ore was usually conveyed to the surface 
and to the mill for dressing. Waste materials were used to fill slopes. 
In these mines, the waste from crosscuts, drifts, and similar places Avas 
transported to the slopes and to other localities Avhere it was needed. 
Generally, transportation was effected by vertical or horizontal means, 
and often by both methods. For vertical transfer downAvard gravity 
Avas usually employed either by raises made especially for the purpose, 
Avhich connected levels Avith levels, or by slopes, Avhich had shafts or 
ore chutes, similar to raises but connecting to the main level. Trans¬ 
portation methods Avere of mechanical and manual types. In the large 
mines, locomotiA^es and haulage equipment Avere commonly used for 
horizontal transportation and skips for vertical transportation. The 
small mines used hand trams. 


30 





Dust was released in all parts of the mines during rock removal and 
during transfer, but by far the largest amount of dust was produced 
during mucking or loading operations. A great deal of dust was also 
produced when ore was transferred from raises and ore chutes to cars. 
W ben meclianical methods were used in mucking dry ore, the dust was 
very exce.ssive. For example, some of the dust counts made in typical 
mines showed (*oncentrations of about 50 million particles per cubic 
loot during sl()j)e filling, 90 million particles during mechanical muck¬ 
ing, and 271 million particles when ore was transferred from loading 
chutes to cars. Concentrations of 50 million particles were found dur¬ 
ing mucking o})erations. On the other hand, some concentrations of 
only 5 million particles ])er cubic foot were obtained during loading 
operations when the ore had been thoroughh" wetted down. 

Illumination in the mine workings came mostly from electric or car- 
hide lam])s worn by the miners. ^Miners had to dei)end on natural 
ventilation through various shafts in the workings. In some of the 
lower levels the ventilation was very had. Unguarded machinery in all 
of the mines and mills caused many serious accidents. Floors in the 
mills were all in had condition, and generally wet. ]\lost stairways and 
platforms were unguarded, and those that did have railings were in 
need of repair. 

In a good many of the mines trans})ortation was by trolley. Low 
trolley wires were unguarded, and many sAvitches were hazards. 

Peru 

At present, no data are available as to the amount of free silica in 
the various ores nor have any dust studies ever been made in Peruvian 
mines. However, some information is available to indicate that free 
silica is present in the ores and, in some instances, in high concentra¬ 
tions. In many of the mines, it was not necessary to make dust de¬ 
terminations to know that miners were breathing high concentrations 
of dust, since the amount of dust created in some of the mines was great 
.enough to he visible to the naked eye. 

Drilling was one of the mining operations which produced great 
amounts of dust. .Most of the drilling was accomplished with com- 
pre.ssed air and although drilling was supimsed to he done wet, dry 
^methods were frecpiently encountered. Invariably the collaring of holes 
•was done dry. In most instances where wet methods Avere employed, it 
'was apparent that an insufficient amount of Avater Avas fed to the hol- 
loAV drill. The one gold mine visited, Avhich Avas said to he typical of 
mines in the Southern area, Avas particularly dusty, since .sufficient 
water Avas usually unavailable. In fact, the Avater used underground 
was brought to the mine in tins attached to oi’e huekids hauled oA’er an 
<S kiloimder aei'ial cable. 

Dust Avas relea.sed in many of the mines during rock removal and 
during transfer, but by far the largest amount of dust Avas produced 

31 



during mucking or loading operations. A great deal of dust was also 
produced when ore was transferred from raises and ore chutes to cars. 
When mechanical methods were used in mucking dry ore, such as in 
scraping operations, the dust was excessive. 

With but one or two exceptions, mechanical ventilation was not em¬ 
ployed in Peruvian mines. When mechanical ventilation was provided, 
it was obviously insufficient in quantity, and in one case it was com¬ 
pletely ineffective because the system was not operating at the time of 
the visit. Natural ventilation was the rule and this was insufficient. 
Even when wet methods were employed, workers were still exposed to 
clouds of dust. Automatic air and water throttles were nonexistent, so 
that it was practically impossible to prevent dry collaring. Mine oper¬ 
ators did not know how much water was fed to the drills, although 
scientific studies have indicated the exact amount of water needed for 
various types of drills and drill speeds. Blasting, which produced tre¬ 
mendous quantities of dust, took place during the lunch hour in all 
mines. There was not enough time between the noon-hour blasting and 
the miners’ return to work for all the dust to settle. All of these factors 
were conducive to the inhalation of excessive amounts of silica dust, 
and the resultant rapid development of silicosis. 

It may be of interest to note in passing that in the fall of 1945 the 
Sociedad Nacional de ^lineria of Peru invited an eminent ventilation 



Dry drilling in a coal mine 


32 



Lead furnace in insoluble anode plant of copper smelter 

engineer of the Ontario ^Mining Association of Canada to study repre¬ 
sentative mines and mills in Peru and to make recommendations for the 
prevention of silicosis. The author of this report surveyed 10 of the 
mines and mills that had been visited by the Canadian engineer. In 
spite of excellent recommendations made by the Canadian concerning 
the prevention of silicosis, the author found that conditions in these 10 
mines were about the same as they had been when he visited them 
nearly 2 years earlier. 

Most of the mills where ore was concentrated were in as poor condi¬ 
tion as the mines underground. Dumping and crushing of ore was done 
with few enclosures and no exhaust ventilation. On the whole, manage¬ 
ment in Peruvian mines has paid little attention to the control of dust 
at its sources, whether it be above or below ground. Although hundreds 
of thousands of dollars are now being paid out in compensation for 
silicosis, no company has tried to find out the composition or concen¬ 
tration of its dust exposures; to insist on wet drilling at all times; to 
provide mechanical ventilation where required; to use wet methods in 
other dust producing operations such as loading and dumping; or to 
make anyone responsible for the maintenance of control methods. Res- 
[)irators used in some of tlie mines and mills were of the unapproved 
type and no maintenance services were otfered when respirators were 
employed. Everything for comi)ensation but nothing for prevention 
seemed to be the rule. Otlier j)ertinent observations on working condi¬ 
tions in the mines will be discussed later in this report, when the sub¬ 
ject of occupational diseases is treated. 


33 














At this point, it may be well to discuss working conditions in the 
large and only smelter in Peru in somewhat greater detail. This smelter 
employed approximately 3,000 persons and produced some 12 different 
products, including lead, copper, and silver. In addition to the smelter 
itself, there were many maintenance shops essential to such operations. 

The foundry which employed about 80 men on one shift was a com¬ 
bination brass, steel, and iron foundry. Housekeeping in this shop was 
bad. On dusty operations, the men wore cloth bag respirators. Sand 
blasting was done outside the building but with no control. There was 
a definite potential silicosis hazard in this shop. 

The machine shop, although offering no occupational disease hazards, 
contained many safety hazards from moving machinery, unguarded 
belts and gears. 

The steel fahrlcating shop contained welding, forging and rolling 
operations. It was observed that many workers who were welding did 
not wear goggles and that many of the welding operations were un¬ 
shielded, thus exposing nonwelders to welding hazards. 

The carpenter shop contained many accident hazards from unguard¬ 
ed moving machinery. 

The ore crushing and grinding departnieiit handled about 2,000 tons 
of ore a day. Some of these ores contained as much as 75 percent total 
silica. There was absolutely no attempt made to control dust on such 
operations as dumping, crushing, grinding, and mechanical conveying, 
so that clouds of dust given off polluted the entire plant. Although most 



Filling a mold with lead in a copper smelter 


34 



I 

j Lead cathode starter machine 

[ workers were supplied with resj)irators and wore them, not a single 
{respirator was of an approved type. 

The copper roaster, nearby, gave off tremendous (piantities of sulfur 
dioxide gas. Nearly 1,200 tons of this gas were discharged through tlu* 
furnace stack every day and irolluted the atmosphere. 

About 12 people worked in the arsetiic department. Although derma¬ 
titis cases occurred in this jrlant, it was claimed that no cases of poison¬ 
ing occurred. Personal hygiene in this depaidment was rather good on 
the whole. The men were furnished clean overalls, bathing facilities, 
and a separate lunchroom. However, case histories on some of these 
men showed symi)toms suggestive of arsenic poisoning. 

The copper furnace room also contained two lead blast furnaces. The 
operations in and about the lead furnaces were mostly unenclosed, so 
that there was ample opportunity for exposure to high concentrations 
of lead dust and fumes. This was especially true at the two lead sinter¬ 
ing machines, which were observed to give otf heavy clouds of lead 
oxide fumes. Other toxic lead locations weie found around the lead 
furnaces, in the production of lead cathode starters, and in the lead 
rolling mill. 

No cases of zinc oxide chills had been reported from the zinc roaster 
department, but the exposure should he studied. 

There were jiotential hazards- from hydrofluoric acid in the hi/dro- 
\fluosiIicic acid, plant. There was also a silicosis hazard in this plant, 
since the raw materials emphyed were free silica, fluorsjiar, and sul¬ 
furic acid. 


35 











There was also a potential silicosis hazard in the hrick manufacturing 
plant. 

This smelter contained many hazards to safety and health. The only 
exhaust ventilation installations observed were those in connection with 
coal pulverizing where it was necessary to protect the plant from dust 
explosions. 



Handkerchief used as a protection against 

acid mist in a copper smelter \ 

The antimony plant was also well controlled, but primarily in order | 
to recover antimony. Housekeeping throughout the entire plant was 
very bad. One could not escape the conclusion that all this was but a 
reflection of the attitude of top management toward health and safety. 

A company as large as this one, employing nearly 12,000 workers in 
all of its operations, would find it profitable, in the long run, to pay 
some attention to the control of occupational diseases. In fact, it would 
be of distinct monetary benefit to the company and a forward step in 
labor relations if management established a full-time industrial hygiene 
department, with responsibility to study and control occupational dis¬ 
eases. Such a department should be responsible only to top manage.- 
ment, so that its recommendations would be put into effect expeditious¬ 
ly. As a start, it would be imperative for this company to employ im¬ 
mediately a trained industrial hygiene engineer who could begin to 
control the many toxic exposures now present in the smelter. 


36 




Chile 

One of the two large copper mines visited in Chile had installed an 
excellent industrial hygiene and safety program within the 2 preceding 
\ears. In that mine, working conditions underground were excellent. 
Some 21o,000 cubic feet of air per minute (approximately 270 c. f. m. 
per man) were moved. In addition to ventilation, many other dust con¬ 
trol procedures were employed. The crusher plant as.sociated with this 
mine was also well controlled from the standpoint of dust exposure. 
Four large fans, each with a capacity of 35,000 cubic feet per minute, 
were in operation. The dust exhausted from crushing operations was 
trapped in four air washers of the water spray type. 

The other large copper mine made only a slight effort to control the 
, silica dust exposure. The greatest source of dust was the gyratory 
crusher building which handled approximately 140 tons of ore per 
minute in its two 60-inch gyratory crushers. The ore was dumped out 
of two gondolas at a time, each holding 70 tons. The mechanism by 
which this ore was dumped into the crusher is shown in one of the 
accompanying photographs. Also shoAvn is the tremendous cloud of 
dust created during this operation which was carried on, as a rule, from 
3 o’clock in the afternoon until 7 in the morning. Considerable ex- 
j posure to dust was also present in the open pit of the mine, where some 
2,700 men were employed; at the various secondary crushers; and all 
the way through the plant up to the leaching vats. The dust at this 
jmine contained approximately 50 to 60 percent silica in the form of 
quartz. 


yirtv of 2-car ore dumper 


37 













Cloud of dust created at 2 gyratory ore crushers (same mill) 


One of the two nitrate mines covered in this survey maintained ex¬ 
cellent conditions in its various crushing, grinding, and bagging opera¬ 
tions. The other had no dust control program. It is true that the 
amount of quartz in nitrate ore is comparatively low; however, the 
dense clouds of dust liberated in the various crushing and pulverizing 
operations in the second nitrate mine should have been controlled if 
only to prevent accidents and damage to machinery. 

Working conditions in the sulfate mine and mill were probably the 
worst encountered in the entire survey. IMuch dust was in evidence and 
the only controls employed were respirators of an unapproved type. 

Serious hazards were found in the mills and smelters maintained by 
the copper mines including those associated with the copper mine whicli 
had instituted an industrial hygiene program. One smelter, which 
maintained a brick ]dant, had a serious silica dust exposure for which 
no control measures were in evidence. In addition, the smelters had ex¬ 
posures to sulfur dioxide, metallic fumes, and excessive heat from th( 
furnaces. The various repair and maintenance shops, which were oper 
ated in connection with the mining establishments, were poorly equipped 
to handle both safety and health hazards. 

On the whole, the survey revealed that some attempts to control occii 
pational diseases and accidents had been made by two of the mining 
establishments and that the other establishments had a long way^ to g( 
to achieve even fair working conditions. Perhaps this lack of healtl 
and safety consciousness on the part of the large concerns at least I 
due to the fact that until now the cost for indemnifying workers fo: 


38 









Cleaniiiff table in a small fish cannery 


accidents or oceiiiiational diseases has not been prohibitive. However, 
in rectMit years silicosis rates (and aiiparently silicosis is about the 
only ocvMpational disease recognized and compensated in (diile), and 
rates for total disability have increased, l^roduction costs have risen 
sufticiently to make management give serious cousideratiou to the im¬ 
provement of working conditions. 


MAmFACTURhyG liSlWSTHlES 

In general, it may be said that with the exception of a few of the 
: manufacturing establishments surveyed, all of the industries in llolivia, 
■ Peru, and Chile are about as backward in industrial hygiene and safety 
. practices as were working establishments in the United States at the 
I beginning of the present century. This is not hearsaj" evidence alto- 
j gether, since the author of this report first began observing industrial 
I hygiene practices in the United States some 28 years ago. 
i For example, in the manufacturing and service industries surveyed 
I in Bolivia only three of the plants—the textile plant, the cement plant, 
; and the airplane repair shop—could be considered modern. Some at- 
j tempt was made to guard machinery and control hazardous operations, 

I and fair sanitary facilities were provided. 

j Conditions in the remaining five Bolivian and in all Peruvian plants 
were not conducive to good health or safety. Illumination and general 
; ventilation were inade(iuate. ^Machinery was coinpletel}' unguarded. 

Electric wires were bare, and almost all hazardous operations were in- 
. effectively controlled, or not controlled at all. IMuch of the machinery 


39 




Flint grinding tnill in a ceramic plant 


was old and badly maintained and most of the j^ower machinery was 
belt driven and unguarded. Grinding whebls were unguarded and un¬ 
exhausted, nor were goggles worn by any of the men using these wheels. 

Housekeeping was, in all cases, poor. Floors were wet and in need 
of repair. In several plants stairs were dark, steep, and unguarded. 
Some of the plants which had mezzanine work rooms had no guard rails 
on these mezzanine floors. Sanitation was gi’ossly inadequate and badly 
maintained. 

Bolivia 

Specific exposures to toxic substances and materials were found to be 
typical of such manufacturing establishments. For instance, in the 
three Bolivian plants manufacturing shoes or processing hides, ex¬ 
posures were found to various dyes, solvents, oils, acids, and other 
chemicals used in hide treating and tanning operations. Some exposure 
was found to gasoline which was kept in open containers. In the textile 
plant, exposures to cotton dust and dyes were common. Humidity was 
high in the spinning, carding, and weaving rooms, and noise was exces¬ 
sive in the weaving room. 

One of the worst plants visited in Bolivia was the glassware plant 
where observations were made during the night shift. Conditions in 
this plant are described here in detail, not because they were excep¬ 
tional, but because they were typical of present-day manufacturing 
establishments in Bolivia. 

The glassware plant contained about all the known health and safety 
hazards one can imagine. It was a typical sweat shop. Crowding was 


40 


I especially hazardous in the manual blowing rooms. Little boys sidled 
I and jostled each other carrying glass-blowing rods, the ends of w'hich 
were molten glass, and constantly exposed themselves to burns. In the 
same room, though unshielded open furnaces and the glaring molten 
glass presented serious eye and heat hazards, w’orkers had neither pro¬ 
tective goggles nor clothing. Adequate air douches to combat the heat 
hazard were also lacking. In other parts of the plant, unguarded ma- 
1 chinery and bare electric wires were all in need of corrective attention. 
I Dust of a toxic nature was present in several of the other workrooms. 
I The respirators furnished the workers in the batch mixing rooms were 
ineffective and badly maintained. In fact, it was just as well that the 
men did not wear them, since they would only have in.stilled a false 
sense of security. Needless to say, sanitary facilities were almost nil. 

' Peru 

! Of the four manufacturing plants wliich handled toxic dusts, such as 
silica and asbestos, only one made any effort to install dust control 
equipment. The remaining three had heavy exposures to dust. The 
cement plant could be spotted some distance away from its location, 
merely by the dust cloud which appeared on the horizon, even during a 
typical Lima winter overcast. In these plants, too, whenever respira¬ 
tors were worn, they were of the cheap, unapproved and ineffective 
variety. The textile mill which produced woolen cloth was very archaic. 
All machinery was unguarded, floors were wet and slippery and the 
few sanitary facilities available were at some distance outside the plant. 
Most of the w’omen workers, of whom there were 350, were Indians and 
wore long braids and many layers of exposed clothing. Both are con¬ 
ducive to accidents from unguarded machinery. 

I Chile 

' Most of the products manufactured in Chile are light consumer 
[goods for domestic consumption. The principal goods made are food 
products; textiles such as cotton, wool, rayon; chemical products; 
leather and leather products; and light machinery. World War II gave 
impetus to the production of manufactured products for home con- 
Isumption; the assistance industry is obtaining from the Chilean De- 
Ivelopment Corporation is another factor in the recent growth of 
industrialization. 

I With the exception of a few’ enterprises, most Chilean industries are 
small and employ few workers. Heavy industry is a recent develop¬ 
ment. For this reason, the country suffers from a shortage of skilled 
labor and technicians. 

It is apparent that Chile must conserve its manpower if it wants to 
compete with other countries which are rapidly developing industrially. 
To date, however, little has been done to conserve the health of workers 


41 






in manufacturing plants. With but one or two exceptions, conditions 
in manufacturing plants in Chile are as backward in health and safety 
practices as those observed in llolivia and Peru. 

OCCUPATIONAL DISEASES 

Occupational disease legislation has been enacted in all three coun¬ 
tries, hut the emphasis is on compensation rather than on prevention. 
The compensation system in all three countries is characterized by 
certain weaknesses, both in the wording of the laws and in their ad¬ 
ministration. At the time of the studies, no reliable statistics on the 
incidence of occupational diseases in each of the countries were avail¬ 
able, but sufficient evidence was found to indicate that such diseases 
occur frequently. 

A characteristic of the compensation laws common to each of the 
countries under study is provision for payments for partial disability 
from silicosis. This is also one of the factors influencing high com¬ 
pensation expenditures for silicosis. This practice overlooks the fact 
that the medical profession does not have the exact scientific tools for 
evaluating partial disability from silicosis. The X-ray is a great aid in 
the diagnosis of chest conditions, but most authorities agree that in the 
field of silicosis it is an inadequate instrument for assessing disability 
from silicosis except in a gross manner. Neither is it possible to assess 
partial disability by daily work capacity, since that criterion varies 
with personal incentive, natural physical and mental endowments, and 
the nature of the job. Clinical criteria are also quite inadequate. A 
thorough study of all the factors involved is needed to arrive at a 
diagnosis of total disability. The problems involved in an attempt to 
assess partial disability are even greater. 

In Peru there seems to be no consistency with regard to the handling 
of partial disability cases. For example, some concerns employ men 
underground with first and second stage silicosis while others pay total 
disability for silicosis in its early stages. In Chile, many concerns 
prefer to pay a worker for partial disability from silicosis rather than 
to keep him on the job and later be faced with a claim for total disability. 

A far better approach to the silicosis problem would be to control the 
dust exposure to a safe limit and keep the man on the job. So long as 
lie does not inhale more dust, his disease in the early stages should not 
})rogress. Only if infection sets in should he be indemnified for total 
disability and taken off the job. Experience in the United States has 
shown that, barring infection, a man with early silicosis is capable of 
doing a fair day’s work, provided he is protected from exposure to 
dust. Indemnifying a worker for partial disability from silicosis does 
him harm rather than a favor, since he finds it difficult to procure 
employment elsewhere. 


42 



littlirid 

lilt* only r(*lial)l(‘ statislios r(*^ar(lin<^ ottiipationa! ai'cidi'iits ainl 
diseases in liolivia are tliosi* of tin* ('aja d(* Sej^uro y Aliorro ()l)rero, 
die jj:overninental agency res])onsil)l(‘ for the national workmen’s eoin- 
pensation Innd. This fund is maintained by eollections from indus- 
trialisls in the form of a pa\n‘oll tax. Compensation is jiaid to work¬ 
men insured with the Caja for certain classifiable occnjiational diseases 
and accidents according to a schedule set uj) by law. 

The present occupational disease law provides for compensation for 
the pneumoconioses—silicosis, antbracosis, cbalicosis, byssinosis, ta- 
bacosis, etc.; metallic poisonings; opbtbalmic diseases; dermatoses; 
ludmonary sclerosis; nejibritis; tuberculosis; and chronic bronchitis. 

During 1946, the Caja insured 35,()()() workers, and indemnified 
11,603 of them for occuiiational accidents and diseases. Of this number, 
231 workers received compensation for total disability from accidents, 
and 10,203 received com})ensation for partial or tenniorary disability, 
being paid anywhere from 50 to 100 percent of their wages for such 
injuries. In addition to these accidents, many more occurred which 
were not compensable by law, since they could not be classified as 
])ermanent or total, or temporary partial. In such instances, the workei- 
received medical and hospital attention only. 

The 10,434 comi)ensable accidents cost 8^ million Dolivianos in 
actual cash. This sum represented only the actual compensation ])aid 
workers for accidents and did not include medical and hospital bills 
and intangibles, such as spoiled work, breakage of machinery, and other 
factors which have been estimated to cost four times as much as the 
actual com|)ensation cost. In other words, work accidents alone really 
cost nearly 50 million IJolivianos in 1946. 

The occuj)ational disease i)icture was even more striking and tragic. 
In the same year, the (’aja de Seguro indemnified 1,169 workers for 
occupational or ])rofessional diseases at a cost of 36 million Dolivianos 
in cash benefits. Thus, occu])ational diseases accounted for about 80 
percent of the total payments made to workers. This ])ercentage was in 
direct contrast with compensation figures in the United States, when* 
benefits i)aid for occui)ational diseases account for only about 5 percent 
of all the money spent on com})ensation for all types of disability. 

If all costs are considered, cash benefits as well as i)roduction losses, 
liolivian industry has beeji spending somewhere in the neighborhood 
of 200 million Ilolivianos a year for accidents and occupational diseases. 

Disability in Dolivian industry is a costly affair not oidy in terms of 
iiuman life and health, but also from the standpoint of economics. As 
a matter of fact, uidess something drastic is done to curb these high 
accid(‘nt and disease raters, manpower will soon be in short supply. 
About one-third of all tin* workers insured with the (’aja were indemni- 
lied for some form of disability in 1946. Obviously, the total disability 

40 





cases were unemployable, since they presented insurance risks too great 
for an employer to take. Unemployable, also, were those who contracted 
silicosis, since totally disabling silicosis, that is, silicosis in the second 
and third stage, renders the worker uninsurable. Those workers who 
received partial disability compensation w'ere also unable to work since 
preemployment physical examinations required by law weeded them 
out of the labor supply. 

A few pertinent observations must be made in connection with these 
high disease and accident rates, not for the sake of exposing unholy 
practices, but in the hope that something constructive can be done to 
eliminate them. 

Because of the low order of education among Bolivian workers, many 
of them deliberately exposed themselves to hazards. For example, many 
of them, in an attempt to contract first-stage silicosis (a compensable 
disease) refused to use the wet drilling methods required by law and 
internal regulations, even though water was right at their elbows. 

Management could have fined a disobedient worker 20 percent of his 
wages for a maximum of 15 days for violating internal regulations. 
(The money received from these fines went to the Minister of Labor 
for the purchase of school books.) A miner, however, was not greatly 
disturbed by such fines, since he still had pulperia privileges. Manage¬ 
ment could also have imposed more serious penalties by laying off the 
worker for 3 or 4 days, during which he lost not only his pay, but also 
his pulperia privileges. Management, however, hesitated to penalize 
the men drastically because of the labor unrest which existed in the 
mines. The miners had issued a manifesto advocating workers’ seizure 
of the mines. Mine labor w^as in a militant mood and not to be trifled 
with. 

Peru 

Although Peru has had an occupational disease compensation law 
since January 12, 1935, it is practically impossible to obtain nation¬ 
wide statistics on the incidence of occupational diseases. The reason 
for this paucity of data is to be found in the manner in which com¬ 
pensation for occupational diseases is administered. For example, if a 
worker believes that he is suffering from an occupational disease, he goes 
before the company physician who examines him. If he finds the 
worker’s claim valid, the doctor certifies him to the company for pay¬ 
ment. If the legal department of the company refuses to pay the claim, 
the worker has recourse to the local judge of the Ministry of Justice and 
Labor. If the claim fails to be adjudicated in the regional office of the 
Ministry of Justice and Labor, the worker’s last recourse is the court 
in Lima. It is apparent, therefore, that whatever data are available are 
scattered and no attempt has been made, so far, to centralize the in¬ 
formation. However, some idea of the incidence of occupational diseases 


U 


in 1 eru was obtained during this survey from the records of a few 
eonipanies whicli collected such information. 

1 he present occupational disease law provides disability payments 
for the i)neumoconioses, and for poisoning incurred from exposure to 
mercury, arsenic, lead, bismuth, carbon monoxide, (piartzite, calcite, 
cement, pitch, and hydrocarbons. Payment of indemnities for these 
causes, as well as for X-ray burns, is made on the same basis as for 
industrial accidents. In addition, acute or chronic pathological dis¬ 
orders, which may be brought on by the inhalation of noxious fumes or 
poisonous substances, are also considered on the same basis as indus¬ 
trial accidents. Two stages of disability are recognized for the pneu¬ 
moconioses, namely, total and i)ernianent disability and partial and 
I)ermanent incapacity. 

One firm which enijdoys nearly 12,()()() workers reported that 271 
cases of silicosis were certified by its medical department for payment 
in 1946. This same firm also reported 16 cases of lead poisoning which 
occurred in its smelter that year. Two years previously the same firm 
had reported 25 cases of lead poisoning at its smelter. Forty-two cases 
of dermatitis occurred in this plant in 1946 and 17 during the first 6 
months of 1947. 

A total disability case in Peru costs 2,400 soles. A worker who re¬ 
ceives total conii)ensation is released, lie is also entitled, by law, to 
service time payment amounting to 2 weeks’ salary for each year 
worked. It is obvious that conij)ensation payments were an expensive 
item in this particular company’s budget. In fact, some half million 
soles ($80,000 at the official rate of exchange) were paid by this com¬ 
pany for occupational disease compensation in 1946. In addition, this 
firm paid $60,000 a year in bonuses to workers exposed to lead hazards. 
This same firm also spent approximately $180,000 to operate its 135-bed 
hospital. No data were available on the amount of money this firm paid 
its workers because of general illnesses. Although not re(pdred by law, 
this company paid its workers half salary for the duration of any ill¬ 
ness. Because of this extra expenditure, it was not possible to figure 
out the total amount of money spent by this firm for disability cases, 
but it certainly must have been close to a half million dollars a j^ar. It 
was quite obvious that this company was wasting not only its own 
capital, but also that of its workers through loss in wages, ill health, 
and inefficiency. A modern preventive health program run by tlie com¬ 
pany, under the leadershii) of the Government, is the only answer. 

Other examples of occui)ational diseases in Peruvian industry are at 
hand. In one mine, which employed nearly 1,500 workers at its various 
installations, some 1,900 applicants for work were examined in 1946. 
Three percent of these were rejected because of silicosis, apparently 
acquired elsewhere. Another mine employing some 500 men examined 
890 applicants for work during the first 6 months of 1947. Nine per- 


45 


cent of these men were rejected because of silicosis and 14 percent be¬ 
cause of tuberculosis. Still another mine, emjdoying about 450 men, 
rei)orted that 8 percent of its workers had silicosis and tuberculosis. 
Another mine, eniployin^ 500 workers, rejmrted 26.1 percent illness 
among* its workers. The causes were i)neumonia, grippe, bronchial pneu¬ 
monia and silicosis. There Avere 84 cases of silicosis at this establish¬ 
ment. At this same mine 19 percent of 815 persons examined for em¬ 
ployment in 1946 were rejected because of silicosis and tuberculosis. Of 
the 156 men rejected for these two causes, 128 had silicosis. And finally, 
the experience of still another mine was available for the period 1935 
through 1942. During those 8 years, out of some 6,499 men examined, 
14.3 percent Avere found to haA-e silicosis. During the same period, onty 
1.9 percent of those examined AA^ere found to have tuberculosis. 

It is obvious from the above data, even though they are from scat¬ 
tered sources, that high rates of silicosis and tuberculosis exist through¬ 
out Peruvian mines and mills. Unquestionably these rates are an under¬ 
estimate, since it is knoAvn that a high labor turnover tends to mask 
true conditions. Labor turnoA^er in the factories is slight, with the ex¬ 
ception of one factory Avhere it Avas reported to be 50 percent annually. 
But in most of the mines it is extremely high, running from 35 and 50 
percent yearly to more than 100 percent, especially for unskilled labor. 

It should be pointed out that there are many factors influencing the 
high labor turnover, among them being the fact that many of the un¬ 
skilled Avorkers like to return to their farms for several months of the 
year during planting and harvesting time. On the other hand, one 
cannot escape the fact that high turnover is due largely to bad working 
conditions, Ioav pay, and extremely bad Ihdng conditions. Much has 
already been made of the fact that the men live in company camps 
Avhere restrictions are placed on their freedom. Workers feel that no 
matter hoAv bad living conditions are on their farms, at least they are 
in their own homes and enjoy a certain sense of stability and freedom. 

At the present time, Peruvian mines are in dire need of labor and 
production is at a low ebb. This survey revealed that anywhere from 
tAvo to three hundred men were needed at each mine and mill without 
excei^tion. A simple computation reveals the fact that the mines in 
Peru could use thousands of men to produce minerals and other re¬ 
sources AA^hich are at hand and AAdiich Avould go a long way toward 
raising the standard of living and the prosperity of the nation. The 
present practice of running mines Avith silicosis hazards, paying off 
men with partial or total disability, and doing nothing to clean up 
hazardous conditions, only serves to deplete the nation's labor force. 
Apparently, something drastic must be done to eliminate the various 
evils discussed in this report, if production and purchasing power are 
to be raised. 


46 


before leaving this section, it is only fair to point out that nianage- 
nient has difficulties in obtaining full-hearted cooperation from the 
workers in its few attempts to control accidents and occupational 
diseases. Because of the low order of education of Peruvian labor, it is 
difficult to get many workers to use preventive measures, such as wet 
drilling. Labor is quite militant in Peru and is difficult to handle, even 
though the labor laws provide for disciplinary action when health and 
safety rules are broken by workers. Experience has shown that educa¬ 
tion is a far stronger weapon than discipline and it would pay manage¬ 
ment to inaugurate an educational program among its workers in the 
field of health and safety. Sucli a i)rogram has been found to be sound 
business practice in other countries. 

Chile 

Chile has had a law providing for comi)eusation of occupational 
or professional diseases since 1927. This law is an extension of the law 
passed in 1925 for the com])ensation of accidental iiijuries, and ])ro- 
vides that diseases developed in the course of em])loyment he given the 
same interpretation as accidents. All wage earners, including agri¬ 
cultural and domestic workers, are covered by the law under a volun¬ 
tary insurance system. A State Insurance Fund competes with ]»rivate 
insurance carriers and employers who have the right of self-insurance. 

The law grants total or partial disability coni])ensation for i)rofes- 
sional diseases and accidents in accordance with the injury sustained. 
Compensation payments are provided for these illnesses: lead poison¬ 
ing, mercurial poisoning, and intoxication produced by copper, anti¬ 
mony, zinc, chrome, barium, manganese, brass, gold, silver, tin, hydro¬ 
carbons, and suliocarbons; diseases caused by infectious and i)arasitic 
agents, such as anthrax, carbuncles, glanders, actinomycosis, tetanus, 
and hookworm; diseases caused by the inhalation of dust, gases, and 
vapors; diseases induced by compressed air; diseases ]U’oduced by toxic 
vapors of resins, tar, and its compounds; silicosis and other forms of 
j)neumoconioses; cellulitis; synovitis; inflammation of the tendons: 
cataracts among glass workers; telegraph operators’ cramps, nystag¬ 
mus; diseases of the joints, muscles, and tendons; mental conditions; 
skin diseases; and diseases caused by exposure to alcohol and tobacco 
in industries which handle the.se two substances. 

There are several deficiencies in the occu]Kitional disease com])ensa- 
tion law as it is written and administered. It is obvious that little .study 
of (’bile’s occupational disea.se problem preceded the formulation of 
the list of disea.ses to be compensated. Tlie list reads as though it were 
copied from laws pas.sed in other countries. Some of tlie diseases list(‘d 
may never occur in (’bile. A few are not oeeui)ational in origin; other.s, 
|)erhaps, should be added. In.sofar as the practical a|)i)lieation of tlie 
law is concerned, silicosis is about the only disease which is recognized 


47 



by physicians and compensation authorities and for which compensa¬ 
tion is granted. 

Because of the statistical system employed in the Labor Department 
and the State Insurance Fund which deals with accidents (Bureau of 
Labor Accidents) and because of incomplete reporting, it is difficult to 
determine the incidence of occupational diseases. For statistical pur¬ 
poses, little distinction is made between occupational diseases and in¬ 
dustrial accidents. In 1946 the Bureau of Labor Accidents paid com¬ 
pensation for only 81 occupational diseases among its more than 300,000 
insured workers. Other factors which preclude accurate statistics are 
high labor turnover, failure of physicians to recognize occupational 
diseases, and ignorance on the part of the workers. 

It is well known that many workers with silicosis are still employed 
in industrial establishments, in which silica in the form of quartz is 
handled. For example, 15 percent of 1,000 copper miners examined in 
1946 were found to have silicosis with varying degrees of disability. 
The company indemnified 62 cases that year. In the same mine, nearly 
500 silicosis cases had been settled during the preceding 12-year period. 
Although dust hazards are now being controlled in this establishment, 
there are still approximately 150 men employed by the company who 
will eventually be compensation cases because of previous dust ex¬ 
posure. 

In Chile, as was mentioned previously, the compensation law pro¬ 
vides for payments for partial disability from silicosis. 

Among other weaknesses of the present workers ’ compensation system 
are the low benefits paid to disabled workers, Avith the exception of 
those paid to workers AAuth total disability from silicosis. 

As has already been noted, little attention is paid to occupational 
diseases other than silicosis. Neither are there any special medical 
boards to decide on controversial claims for occupational diseases. 

No credit is given to industry for improvements made in Avorking 
conditions; management is thereby robbed of an incentive for main¬ 
taining a preventive program. There is no second injury fund in Chile 
to remove the burden created by the aggraAmtion of a previous injury 
from industrial management. This is a serious deterrent to the employ¬ 
ment of AAmrkers Avho liaA^e been injured, since employers are loathe to 
hire such poor insurance risks unless they are protected by a second 
injury fund. There is but a token amount of Avork being done to re¬ 
habilitate injured Avorkers. The country is thus robbed of potentially 
productive Avorkers and burdened needlessly from the point of view of 
AA^elfare costs. 

Perhaps the most serious flaAv in the entire administration of the 
compensation hnv is the lack of an adequate program for the preven¬ 
tion of disability among AAmrkers. This Avill be treated further in the 


48 


discussion of governmental agencies -which operate in the field of indus¬ 
trial hygiene. 


SAFETY PROVISIONS 

Although the elimination of safety hazards is not considered to be 
an integral part of an industrial hygiene program in most countries of 
the western hemisphere, the subject was considered during the present 
survey. In the few plants which had personnel responsible for safety 
practices, many obvious safety hazards were found to exist. Even in 
fairly new manufacturing plants, machinery was unguarded and poorly 
maintained. The extent to which safety provisions were made available 
to the workers in the establishments surveyed in the three countries is 
shown in table 6. 


Table 6 .—AvaUahilily of safety provisions in all plants siin^eyect in Bolivia, Pern, and Chile 



Bolivia 

Peru 

Chile 

Provision or service 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manii- 

factur- 

ing 

Establishments surveyed. 
Workers included._ 

2.3 

26,488 

15 

23,774 

8 

2,714 

21 

22,935 

16 

20,530 

2,405 

21 

46,089 

8 

34,552 

13 

11,537 



Percent of workers to whom service is available 

Safety director: 

Full-time__ 

19 

21 


55 

60 

7 

53 

68 

8 

Part-time 

36 

35 

44 

15 

17 





Shop committee 

(‘) 

31 

(‘) 

35 

(') 


31 

42 


Health and safety com¬ 
mittee_ 




33 

42 

6 










Number of plants providinR service* 

Safety director: 

Full-time_ 

1 

1 


8 

7 

1 

6 

5 

1 

T^nrt-timp 

3 

1 

2 

4 

4 





Shop committee 






4 

4 


Health and safety com¬ 
mittee 

1 

1 





5 

4 

1 










‘ OrRanizinR. 

* Percent not computed because of small numbers. 


Bolivia 

In Bolivia, onl}^ one mine employed a full-time safety director. This 
jierson, however, did not spend his entire time on safety problems since 
he frecjuently served as a section boss in the mine. Three other estab¬ 
lishments had part-time .safety directors. Shop safety committees in 
the.se plants were nonexistent, although one tin mine and mill indicated 
that such a committee was being organized. In one mine, a health and 
safety committee functioned. Such committees have been found ex¬ 
tremely useful in the control of health and .safety hazards in some of 
the more highly industrialized nations of the world. 


4 !) 

























































Pern 

Eight establishments surveyed had full-time safety directors, and 
tour plants employed them on a part-time basis. In none of the Peruvi¬ 
an industries surveyed were there such instrumentalities for the im¬ 
provement of health and safety as shop; committees or joint labor- 
management health and safety committees. 

This hick of attention to safety was reflected in the accident experi- 
(uice of many concerns. One large establishment with a population of 
nearly 12,000 workers experienced 14 deaths and 1,006 lost-time acci¬ 
dents in 1946. This experience yields a frequency rate of 39.87 per 
million man-hours of exposure. One mine which employed 1,500 persons, 
and which had obvious safety hazards both above and below ground, 
experienced 1,410 minor accidents, 31 serious and 10 fatal accidents 
in 1946. 

No current national statistics were available for accidents in mines, 
but data Avere at hand for 1944. In that year there Avas a total of 2,854 
accidents in the mines and mills. For manufacturing plants, the latest 
data available AA^ere for 1945, AA^hen a total of 18,310 accidents Avas 
reported. 

Chile 

Although Table 6 indicates that flA^e of the mining establishments and 
one manufacturing plant had full-time safety directors, only three 
comDanies employed men in this capacity. One of these companies 
operated a coal mine and a ceramic plant; another operated a copper 
mine, smelter, and repair shop; and the third, a copper mine and 
smelter. The first company held safety classes for Avorkers; the other 
two !iad shop safety committees. 

The one coal mine visited during the surA^ey Avas reputed to .be the 
best mine of that type in operation. IIoAveA^er, safety hazards Avere 
found both underground and on the surface. 

Health and safety committees functioned in one glass plant, in a 
copper mine and smelter, and in establishments of another copper 
company. 

The lack of attention paid to the safety of Chilean Avorkers is 
dramatically reflected in accident statistics for the year 1946. Accord¬ 
ing to information obtained from the Labor Department, some 90,000 
accidents occurred in Chilean industry that year. ]\Ianufacturing con¬ 
tributed nearly 30,000 accidents to the total; agriculture, approxi¬ 
mately 16,000; and mining, 14,000. In other AAmrds, these three indus¬ 
tries accounted for tAvo-thirds of all accidents Avhich occurred. In 
passing, it should be noted that agricultural Avorkers sustained a rela¬ 
tively high number of accidents. Although accidents and occupational 
diseases are rarely associated with agricultural pursuits, problems of 
this character have been on the increase in these occupations largely 


50 


as a result of advances in farm mechanization and the increasing use 
of toxic insecticides. Experience all over the world indicates that just 
as much attention should be paid to industrial hygiene and accident 
control work for those engaged in agriculture as for those engaged in 
manufacturing and mining. 

Chile’s accident statistics in 1946 show that accidents and costs are 
! on the increase. (Although occupational disease statistics are included 
I with those for accidents in Chile’s records, the former make up a very 
small part of the total.) In 1946, accidents increased 45 percent over 
: 1945, and 37 percent over 1944. It is of interest to estimate the mone¬ 
tary cost of industrial accidents. 

According to Labor Department statistics, approximately 90 million 
pesos were paid out in compensation alone. It is now well established 
through careful studies that the hidden costs of accidents, such as those 
involved in breakage of machinery, time lost by other workers when a 
, fellow worker is injured, and other similar losses, average four times 
; the compensation costs. In other words, the sum lost because of acci¬ 
dental injuries in Chile in 1946 was approximately 360 million pesos. 
To that sum must be added the cost borne by the nation because of loss 
of production. Some estimate of this sum can be obtained by an 
analysis of statistics furnished by the Bureau of Labor Accidents. 

In 1946, this organization kept accurate data on 60 industries which 
employed 17,764 workers. In these 60 industries, accidents accounted 
for the loss of 68,699 work days. On the average, each worker in the 
60 plants lost about 4 days a year because of accidents. If we apply 
this figure to the whole of Chile’s labor force, we arrive at a loss of 
about 7 million work days a year. Taking an average wage of 30 pesos 
a day per worker and estimating that a Chilean worker produces goods 
valued at 170 percent of his wages, each worker may be said to produce 
50 pesos of goods a day. Fifty pesos lost for 7 million days a year 
produces a loss of 350 million pesos of j)roduction value for the nation. 
Adding this figure to the 360 million pesos ])aid for compensation, it 
is evident that industrial accidents cost Chile some 700 million pesos 
annually. 

At this point it may be of interest to make a comparison between 
accident experience in Chile and in the United States, where there has 
been an active preventive program for a good many years. In the 
United States accidents in industrial pursuits account for only 0.7 
of a day of lost time per person per year. Even if we take into con¬ 
sideration the fact that occupational diseases are included along with 
accidents in Chilean statistics, we are still confronted with the in¬ 
escapable fact that nearly six times as much time is lost from work 
because of accidents in Chile as in the United States. These figures 
are significant, since work accidents can practically always be i)re- 
vented. 


51 


SANITATION FACILITIES 

Sanitation facilities in Bolivian and Peruvian mines and mills, and; 
in manufacturing establishments as well, are wholly inadequate andi 
in a terrible state of maintenance. In some mining communities, 
workers have no facilities for the disposal of human excreta and use the. 
neighboring hills^ for this purpose. Such practice helps to spread com¬ 
municable disease, which is already prevalent throughout these coun¬ 
tries. Water supplies, washing facilities, personal clothing lockers, and 
other sanitary facilities are completely lacking in many establishments 
and are entirely inadequate in others. 

Chilean workers fare a little better in that sanitation facilities, 
though sometimes inadequate, are available to most of them. Toilet 
facilities, however, are generally insanitary; washing facilities are 
sometimes lacking; and clothing locker facilities are not always pro¬ 
vided. A summary of the availability of sanitation and certain welfare^ 
facilities in all plants surveyed in each of the three countries is pre-1 
sented in table 7. 

Bolivia 

Sanitation facilities in the 23 plants surveyed were grossly inade-' 
quate. Three plants had no water supply at all. Public or private 
water supplies were available in 20 of the plants in which 97 percent 
of the workers were employed. In most instances, the water came from 
wells which were not of approved types. 

Drinking facilities were available in 14 plants which employed 85 
percent of the workers. Only two of these plants had drinking foun¬ 
tains. In the remaining plants, workers drew water from spigots and 
shared common drinking utensils. 

Washing facilities were lacking in 10 mines and one factory. Nine 
plants, employing 55 percent of the workers, provided wash basins 
or sinks. Eight plants, employing 63 percent of the Avorkers, supplied 
a few shoAvers, but only one or tAA^o of these had hot water. Six plants, 
employing 13 percent of the workers, had running cold Avater, while 
six other plants, employing 53 percent of the workers, provided both 
cold and hot running Avater. In most instances, the plants provided 
neither towels nor soap. 

Toilet facilities were available in seven manufacturing plants and in 
six mining and milling establishments. In the mines they Avere chiefly 
of the pit privy type. In general, these facilities were inadequate 
as to number and type, Avere located in foul, dank, and dark enclosures, 
and were revoltingly insanitary. 

SeAA'age disposal facilities Avere provided in 12 of the 23 plants sur¬ 
veyed. Six plants had public disposal systems and six used private 
disposal methods. 

Little attention Avas paid to other personal comfort facilities. Very 


52 





few plants provided workers with individual lockers. A few such 
iockers were found in four plants, which employed 8 percent of the 
workers. Two small plants had separate locker rooms. Only two 
mining establishments had lunchroom facilities for their workers. 

Peru 

I 

I Sanitation facilities in the 21 establishments surveyed in Peru were 
[likewise grossly inadequate. Public water supply systems were avail¬ 
able to four plants. The remaining 17 establishments, which employed 
The majority of the workers in the survey, were furnished water from 
private systems. In only one plant was the water filtered. In most 
instances the water came from unapproved sources, and in some of the 
mining camps the water supply was scarce. 

No drinking facilities were available in seven establishments, em¬ 
ploying 15 percent of the workers. Eight establishments, with 44 per- 
|cent of the workers, had drinking fountains. In five establishments 
[workers drew water from spigots, and in three others open buckets 
I and carboys were used. 

i No washing facilities were available in 13 establishments, employing 
[almost one-half, or 41 percent, of the workers surveyed. One of these 
[establishments was a manufacturing plant, and the rest were mining 
enterprises. Seven plants, employing 43 percent of the workers, pro¬ 
vided wash basins or had spigots available for washing purposes. 
Seven plants, employing 56 percent of the workers, provided some 
showers. Only two establishments, a mine and a smelter, provided both 
hot and cold running water, and two of the manufacturing establish¬ 
ments provided individual towels and soap. As a rule, towels and soap, 
when used, were provided by the workers themselves. 

Toilet facilities in the plants and mines were even worse than those 
provided the men in their homes. Flush toilets were available in only 
two of the mining enterprises and in four of the manufacturing group 
'of establishments surveyed. In the remaining 15 establishments cover¬ 
ing 64 percent of the workers, facilities consisted of latrines, ditches or 
troughs, and cans underground. One large mine provided no under¬ 
ground facilities whatsoever. In general, these facilities were inade¬ 
quate and grossly insanitary. 

' Only 3 percent of the establishments, employing 4 percent of the 
workers, had jiublic sewage disposal systems, while six used ])rivate 
methods of sewage disposal. In the remaining 12 establishments (all 
in the mining groui)) whicli employed 48 percent of the workers, either 
no sewage (lis})osal facilities were provided or open ditches were used 
for this purpose. 

Lockers for street clothing were tlie exception rather than the rule. 
They were pi-ovided by three jilants, employing 6 percent of the 
workers. Two of these plants were in the manufacturing group of 


53 


industries. One other plant was building locker rooms at the time of 
the survey. 

Lunchrooms or space for eating at the work place were provided by 
four establishments and in four of the mines underground. These 
covered a little over one-third of the surveyed population. Seven 
establishments provided no space, although most of the workers ate 
their lunch at the work place. In six of the mining enterprises the 
workers went home for lunch, as did the mill workers in seven of the 
mining and milling establishments. One camp provided a dining room ' 
for single men where they could get three meals for one sole per day. 
One of the plants not only provided lunchrooms for its workers, but , 
also served coffee at 4 o’clock in the afternoon. These were the only 
instances encountered in which management undertook supplementary 
feeding. 

Chile 

Sanitation facilities were provided in most of the 21 establishments 
surveyed in Chile. 

Sewage disposal systems were available in all establishments studied. 
In one nitrate plant and at one copper mine and smelter the sewage 
was treated fairly thoroughly. 

Public or private water supplies were likewise available in all the 
plants surveyed. In 10 establishments, employing 28 percent of the 
workers, drinking fountains were furnished. In 10 other establish¬ 
ments, employing a similar number of workers, the only drinking 
water available had to be taken from spigots, while in 4 mining estab¬ 
lishments the workers carried their own water in canteens. Three 
establishments provided both fountains and spigots. Drinking utensils 
were usually of the common type. 

Washing facilities were lacking in two mining and in three manu¬ 
facturing establishments, which employed 26 percent of the population 
surveyed. Sixteen establishments, employing 74 percent of the -workers, 
provided wash basins or sinks. Six mining establishments, employing 
71 percent of the workers, provided showers with both hot and cold 
water. Two manufacturing plants provided cold showers. 

Toilet facilities were provided in all establishments except one mine. 
These were of the flush type in 19 establishments, pit privy type in 1 
mine, and chemical toilets in another mine. In general, these facilities 
were inadequate and insanitary. 

Lockers were available in six mining and in nine manufacturing 
establishments which employed 72 percent of the workers. In one 
factory clothes hung on wall nails. 

Feeding facilities at workplaces were provided in three mining and 
in one manufacturing establishment. No facilities were provided in 
10 establishments; and in 7 others, the workers lived close to their 
homes and went home for lunch. 


54 


Tnl»lo 7.— \railahilily of sonilafion otol trriforr pntv’sutns in nil pinnis snrrryrd In 

lio'irin. Pern, and (ihile 


I’rovision 

1 _ 


Bolivia 



Peru 


(Oiile 

Ml es¬ 
tablish¬ 
ments 

^Mf'ing 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

rstaldishnient.s .snrveyed. 

2.3 

15 

8 

21 

10 

5 

21 

8 

13 

Workers ineluderl_ 

20,488 

23,774 

2,714 

22,935 

20,530 

2,405 

40.089 

34,552 

11.537 



Percent of workers to whom 

service is available 


Water supply: 










Public_ 

32 

25 

93 

9 

4 

48 

20 

1 5 

57 

Private_ 

0.") 

71 

7 

91 

90 

52 

74 

85 

43 

Sewacre disposal: 










Public_ 

12 

4 

80 

4 

2 

18 

20 

15 

57 

Priv'ate_ 

.50 

on 

19 

48 

44 

82 

74 

85 

43 

Open ditch or none_ 

32 

30 

1 

48 

54 





Drinkine facilities: 










Fountain__ 

5 


48 

44 

47 

15 

28 

23 

41 

Snieot... 

80 

83 

52 

18 

11 

75 

28 

17 

59 

Fanteena, other_ 




23 

2 1 

11 

45 

00 


None_•__ 

15 

17 


15 

10 





Washing facilities: 








81 

Ttasin_ 

/)/> 

50 

99 

43 

42 


74 

71 


Shower_ 

03 

02 

70 

5^ 

50 

55 

57 

71 

13 

Cold water only_ 

13 

0 

44 

.37 

.34 

00 

17 


00 

Ifot and cold water_ 

53 

53 

55 

22 

25 


57 

71 

15 

None_ 

34 

38 

1 

41 

42 

34 

20 

29 

19 

Toilet facilties: 










FI ush_ 

oo 

50 

99 

30 

20 

50 

73 

04 

100 

Privy, latrine, ditch_ 

31 

35 


04 

07 

41 

22 

29 


None__ 

14 

15 

1 

0 

7 


5 

7 


T,ockers provided_ 

8 


81 

0 

5 

15 

72 

71 

73 

Feeding facilities at work- 










place: 










Space provided_ 

33 

35 


30 

39 

15 

42 

54 

0 

Space not provided_ 

07 

05 

ioo 

32 

30 

44 

40 

44 

52 

Workers eat at home_ 

(') 

(') 

(') 

32 

31 

41 

12 

2 

42 



Number of establishments providing service 

2 


Water supply: 










Public_ 

0 

9 

4 

4 

2 

2 

10 

1 

9 

Privat«_ 

11 

10 

1 

17 

14 

.3 

11 

7 

4 

St'wage disposal: 










Public_ 

0 

1 

5 

3 

1 

2 

10 

1 

9 

Private__ 

0 

4 

2 

0 

3 

3 

11 

7 

4 

Open ditch or none 

11 

10 

1 

12 

12 





Drinking facilities: 










Fountain_ 

2 


2 

8 

0 

2 

10 

5 

iy 

Si)igot__ 

12 

0 

0 

5 

3 

2 

10 

2 

8 

Canteens, other_ 




3 

2 

T 

4 

4 


None 

<> 

0 


C)7 

(*)7 





Washing facilities: 








Masin__— 

<) 

2 

7 


4 

3 

10 

0 

10 

Shower___ 

8 

0 

3 

7 

4 

3 

8 

0 

2 


0 

9 

4 

8 

4 

4 

8 


8 

Hot and cold water_ 

0 

3 

3 

2 

2 


8 

0 

2 

None__ 

11 

10 

1 

(»)13 

(»)12 

1 

5 

2 

.3 

Toilet facilities: 










Flush... 


2 

7 

0 

2 

4 

19 

0 

13 


4 

4 


15 

14 

1 

2 

9 


None 

K)' 

9 

1 

1 

1 


1 

C)i 


l/ockers provide*!_ 

4 


4 

3 

1 

2 

15 

0 


Fe<*ding facilit i( a at work- 










place: 










Space j)rovitl(*d_ 

2 

2 


8 

0 

0 

4 

3 

1 

Space not provided_ 

2T 

13 

8 

7 

5 

2 

10 

4 

0 

Workers eat at home... 

_ 

(') 

(') 

(') 

13 

(")12 

1 


1 

0 


' Not (letennincd. 

* P«‘r(u*nt not coniputod hecau.s«‘ of «mall ruiinlxTs. 

* InclinleH iiiiniiiK estaMislimcnta when* provisions diffor for undcruround and mill workers. 
< Mine. 


















































































































MEDICAL SERVICES 

The availability of medical services in tlie establishments surveyed 
in each of the three countries is presented in table H, which gives the ! 
proportion of workers provided with services and the number ot 
establishments providing the service or facility. On the whole, the 
figures indicate a high percentage of facilities in groups of establish¬ 
ments under study, but the figures are for most part misleading when 
one takes into consideration the type of facilities provided. This is 
especially true in Bolivia and Peru, where medical services are grossly 
inadequate from the standpoint of quality and quantity. Workers in 
Chile fare considerably better as will be explained in the following 
discussions. 

Bolivia 

Some form of medical service was offered in all but three of the 
establishments surveyed and was available to 97 percent of the workers 
involved. Plant physicians, on a full-time, part-time or on-call basis, 
were retained by all but three of the plants. Ten mining and milling 
plants, employing 86 percent of all workers surveyed, had full-time 
physicians. No full-time physicians were found in any of the manu¬ 
facturing or service industries. Two mines and mills and four manufac¬ 
turing plants employed part-time physicians. Four other manufacturing 
plants had physicians on call. Sixteen percent of all the workers sur¬ 
veyed were covered by these part-time services. 

Preplacement examinations were given in all but two establishments. 
Periodic examinations, however, were given in only three of the plants, 
and, in those, only upon a worker’s request. 

These plants employed 66 percent of all the workers surveyed. Part- 
time nursing services were never used. 

First-aid facilities were available to a large proportion of the 
workers surveyed. Seventeen plants, employing 82 percent of the 
workers, had first-aid rooms; 15 plants, employing 89 percent of the 
workers, had first-aid kits; and eight plants, employing 62 percent 
of the workers, employed trained first-aid workers. These facilities 
were fairly well distributed among the mining and manufacturing 
groups. 

Evidence of hospital facilities made available to workers by their 
employers was also found. Two types of hospital facilities were 
observed, company-owned hospitals and contract hospitals. Seven of 
the mines, employing 87 percent of the workers in this group of indus¬ 
tries, operated their own hospitals. Another mine, employing 3 per¬ 
cent of the workers, had a contract with a private hospital for the 
hospitalization of its workers. Four manufacturing plants, employing 
78 percent of the workers, had similar arrangements. In other words, 
hospital facilities were available to 89 percent of the workers included 
in this survey. 


56 



Dental services were available to 86 percent of the workers. Five 
mining establishments emj)loye(l full-time dentists, while three others 
retained part-time dentists, as did three of the manufacturing estab¬ 
lishments. 

Nursing services, on the other hand, were less common. Nine mines 
and mills and two manufacturing plants had nurses on full-time duty. 


Table 8.— Ai'ailnh 


ihfy of medical provisions and services in all planis surveyed in Bolivia 


Peru, and Chile 


Provision or service 

Bolivia 

Peru 

Chile 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

Establishments surveyed. 

23 

15 

8 

21 

16 

5 

21 

8 

13 

Workers included_ 

26,488 

23,774 

2,714 

22,935 

20,530 

2,405 

46,089 

34,552 

11,537 


Percent of workers to whom service is available 

Hospital: 










Company owned_ 

78 

87 


87 

98 


77 

98 

13 


11 

3 

78 

6 

2 

45 




First-aid room_ 

82 

82 

86 

98 

98 

100 

98 

ioo 

91 

First-aid kit_ 

89 

89 

92 

100 

100 

100 

100 

100 

100 

Trained first-aid worker.. 

62 

60 

84 

96 

96 

93 

98 

100 

91 

Physician: 










Full-time. _ 

86 

96 


87 

98 


77 

98 

13 

Pnrt-time 

11 

5 

61 

10 


93 

37 

29 

62 

On mil 

5 


47 

3 

2 

7 

6 


25 

Nurse: 










Full-time- 

66 

68 

48 

92 

98 

41 

93 

100 

72 

Dentist: 










Pilll-time _ 

55 

62 


55 

62 


45 

56 

13 

Pflr^’-^^ime _ 

31 

28 

56 

9 

10 


41 

42 

39 

On f* *nll _ 



8 

7 

18 

3 


11 

Physical examinations: 










Preplacement_ 

99 

99 

100 

97 

98 

93 

95 

98 

86 

Periodic- 

8 

4 

42 

39 

41 

18 

67 

71 

55 


(') 

(*) 

(*) 

24 

27 


77 

98 

15 

Medical care provided 








87 

97 


62 

69 


78 

98 


Environmental hygiene 









program- 

55 

56 

44 

2 


18 

15 

17 

() 


Hospital: 

Company owned. 

Other arrangement- 

First-aid room- 

First-aid kit- 

Trained first-aid worker.. 
Physician: 

Full-time- 

Part-time.. 

On call- 

Nurse: 

Full-time... 

Dentist: 

Full-time.. 

Part-time.. 

On call__ 

Physical examinations: 

Preplacement- 

i’erio<lic_ 

X-ray included—-- 

Medical care provided 

families of workers.- 

Environmental hygiene 
program_ 


Number of plants providing service* 


7 

7 

1 

12 


14 

14 


9 

7 

2 


A 

3 

1 

15 

9 




») 

17 

5 

20 

5 

19 

8 

11 

15 

9 

6 

21 

16 

5 

21 

8 

13 

8 

3 

5 

18 

14 

4 

19 

8 

11 

10 

6 

10 

2 


14 

14 


9 

7 

2 

4 

4 

4 

8 

2 

6 

4 


2 

1 

5 


5 

4 





11 

9 

2 

16 

15 

1 

16 

8 

8 

5 

6 

5 

3 


4 

4 


5 

3 

2 

3 

4 

4 


8 

4 

4 

4 

2 

•> 

2 


2 

21 

3 

(‘) 

13 

1 

8 

*) 

19 

5 

15 

3 

4 

2 

17 

13 

7 

6 

10 

7 

(■) 

(') 

*> 

2 


10 

7 

3 






11 

A 

11 


6 

6 


11 

7 

4 

2 

2 


2 

4 

3 

1 











* Not determined. 

* Percent not computed because of small numbers. 


57 


















































































































With the exception of one or two hospitals which were well staff 
and equipped, most of the facilities available to the mine and m 
workers in Bolivia were comj)letely inadequate by ordinary stancWinj 
One mine, which claimed it had a hospital, made no ])rovisions t| 
separate rooms for men and women, and had no instruments or medi(| 
equipment. 


Peru 

According to Peruvian law 


mines and mills which have a stij 
of 50 or more and are situated more than 00 hours from a reside I 
certified physician, must have a staff' physician residing permanently 
on the site. Those establishments with 100 or more persons must pu 
vide dental consultation at least weekly, and if the i)ersonnel is l,5'|i 
or more a permanent dental service must be provided. Establishmer?* 
employing more than 2,000 persons in a locality where no hospital 
available within 50 kilometers must provide a hospital. Those niin^ 
with less than 50 persons must provide at least a medicine chest ai'J 
a male nurse trained in first-aid. ! 

IMedical services on full-time or limited basis were offered in all b ; 
Cine of the establishments surveyed. In the factories, however, tl|! 
raedical services were of a part-time character. j 

Hospitals were owned and operated by Id establishments in tl 
mining group of industries, covering 87 percent of the workers. Oi 
construction project had hospital arrangements with the Servicio C- 
operative Inter-Americano de Salud Publica, and two of the manl 
facturing plants had arrangements with the National Social Insuran] 
I'hi] id for hosi)italization of their employees. 

A total of 35 full-time physicians were employed in the mining i| 
clustries surveyed. These were chiefly employed in connection will 
hospitals operated by these companies. However, two mining cam]l 
employed physicians on an “on call” basis. No full-time physiciaii 
crere retained by any of the five manufacturing plants. Four of the;: 
retained physicians on a part-time basis and one on an “on call' 
basis. 


Full-time nurses were employed by 15 establishments in the minir 
group and by one plant in the manufacturing group. Very few traine 
nurses were observed with the exception of those employed in the lar^ 
hospitals maintained by two large mining concerns. IMost of tl 
medical assistants were practical nurses, or practicantes, as they ai 
calhul. ]Most of the smaller mines, that is those em])loying less tha 
£00 persons, had hospitals with anywhere from 6 to 10 beds, but thei 
could only be classed as first-aid stations. As a rule, these hospita 
v/ere poorly equipped and the one doctor in attendance not only ha 
to take care of all the workers, but their families, too. For exampl 
cne mine, employing nearly 1,500 persons, of whom 800 worked unde 
ground, had only one physician in attendance who looked after all tl 


58 


worKeis ami their families. This meant that one j)hysieian had to look 
after six oi seven tiioiisaml jx'oph* with only three j)raetieantes to 
iiNsist him. I In* hos])ital was (‘xtremely inachxjuatt* ami insanitary. It 
i-ontained just 10 l)e(ls, which liad no springs or mattresses, hut merely 
planks. Sick people had to hrinj; their own heddin*?. 

There were few excei)tions to this state of affairs. On the whole the 
medical and hospital facilities provided most of the workers in the 
mines visited were "rossly inadecpiate. Furthermore, the physicians in 
these localities were so overworked that about all they had time to do 
was to render first-aid and emergency medical care. In only one plant, 
one belonging to the Government, was there a i)hysician who also had 
responsibility to do something about the jirevention of occupational 
diseases and illnesses. 

First-aid facilities were j)rovided in practically all establishments 
surveyed. The construction project did not have a first-aid room nor 
a trained first-aid worker, hut it did have a first-aid kit. One coal 
mine and a glass manufacturing })lant had no trained first-aid workers, 
but the forniei’ employed several practical nurses and maintained a 
hospital. Some of the mines had underground first-aid stations. 

Although ])hysical examinations before employment are recjuired by 
(law, two establishments did not comply with this i)rovision. Periodic 
(examinations were only conducted in two factories and in three mining 
jestablishments. In spite of the fact that silicosis is a major health 
(hazard in the mines of Peru and the X-ray a valuable tool in the 
idiagnosis and medical control of this disease, only two mines utilized 
'the X-ray during preemployment examinations. Another was ])lan- 
ning to do so. As a resvdt, most of these establishments were hiring 
some men who umpiestionabl}’ were already silicotic. One would expect 
that some of these plants would at least install an X-ray machine for 
their own ])rotection so as to weed out silicotics who might ])ut in a 
flaim later. 

Few establishments gave dental services as recpiircd by law. Fight 
fstahlishments in the mining group, employing ()4 percent of the 
workers, maintained full-time or i)art-time dentists. Two other estab¬ 
lishments in this grouj) and two in the manufacturing group had 
dentists on call, hut in most instances these services were not in 
xistence. 


(Me 

Chile has had medical care, social security, public health, and .social 
welfare programs since the passage of its famous Law 4054 on Septem¬ 
ber 8, 1024. This law covers practically the entire working jmpulation. 

Xo attemi)t will he made in this report to discuss the ramifications 
of Chile’s social security system, since this has been done adeipiately 
by many .students of the problem. An attempt will he made to indicate 

818918—40—>5 ... 

o!) 





how the social security benefits provided impinge on the health ai 
welfare of industrial workers. 

Medical services and plant dispensaries required by Law 4054 wei 
available in all but two of the establishments surveyed—the canne] 
and the printing shop. In these two plants a physician was availab 
on an “on-call” basis, but no other medical facilities were provide 
Full-time plant physicians were retained by seven mining and tT| 
manufacturing establishments covering 77 percent of the survey»i 
population. These establishments owned and operated their o'v| 

hospitals. I 

Part-time physicians w^ere employed by two mining and six man 
facturing establishments, and in the remaining five manufacturi] 
plants the physicians were on an “on-call” basis. These physicians we' 
usually supplied by the Workers’ Compulsory Insurance Fund. 

Nurses were employed by all eight mining and by eight of the , 
manufacturing establishments for hospital work and for plant d| 
pensaries. These services were available to 93 percent of the worke 
surveyed. A few of the large companies employed other medical perso 
nel, such as technicians and pharmacists. The hospitals operated 1 
some of the large mining concerns were well equipped, staffed ai 
maintained. 

Full-time dentists were employed b}^ three mining and two man 
facturing establishments. Part-time services were provided in eig 
establishments, while in two others dentists were “on-call.” 

First-aid facilities, including a first-aid room and trained first-a 
workers, were' available in all but two of the plants surveyed. Fin 
aid kits were available in all the establishments. 

Chile’s Preventive Medicine Law, which was enacted early in 191 
provides for free periodic compulsorj" medical examinations f 
workers. The law is administered by the Workers’ Compulsory Insi 
ance Fund. ‘ 

Preplacement physical examinations were given in all but four ^ 
the establishments surveyed and reached 95 percent of the werkeii 
Periodic examinations were given for employees in 13 establishmen 
employing 67 percent of the workers. Chest X-rays were included 
the physical examinations given in 10 establishments, employing 
percent of the workers. One mine took X-rays of all workers who hi! 
worked in other mines and made stool examinations on miners comii! 
from mines where hookworm was known to be prevalent. | 

The practice with regard to periodic examinations differed fro 
plant to plant. Usually they were given annually. In two establisi 
ments such examinations were voluntary. One company reexamined i 
old workers two or three times a year, while a glassware plant wi 
a definite silicosis hazard examined its men twice a year. 

In eleven of the plants surveyed medical services were also provid( 
for workers’ families. 


60 




It is pertinent to the present discussion to note that the Preventive 
Medicine Law is in })rinciple perhaj^s the finest social law which the 
country has passed. From the stan(lj)oint of industrial hyjiiene, how¬ 
ever, there is a weakness in its application. The law does not utilize 
the physical examination as an aid toward the i)roper i)laeement of the 
worker. In reality, an examination made under the provision of the 
law is a periodic examination and not a })reemplo3unent or preplace¬ 
ment examination. Most often, except in lar^e concerns which employ 
physicians on a full-time basis, preemployment physical examinations 
are given by physicians employed by the Workers’ Compulsory Insur¬ 
ance Fund. These physicians are unacquainted with the specific re- 
(luirements of jobs in industrial plants. In fact, it is doubtful if many 
of them have ever stepped inside such a plant. As a result, they are 
not able to utilize the physical examination as a means of placing the 
worker in the right job. In the United States and in (Jreat IJritain 
this technique has been developed into a useful tool and is a new 
approach, i)articularly in regard to the employment of jtersons who 
are i^hysically handicapped. In the past a person’s handicai)s were 
listed by the physician and sent to the employment department. Today 
the practice is to list a person’s abilities and to match them with tin* 
physical and mental requirements of a job. In this manner, every 
})rospective worker has an opportunity for useful employment. Such 
an approach is especially to be commended to a nation like Chile which 
needs every trained person it can muster. 

Another aspect of Chile’s medical care program deserves mention. 
Although close relationships are maintained between the various social 
insurance funds and the ]\linistry of Health, Social Insurance and 
Social Assistance, these relationshii)s ap})ly only to the administration 
of the funds and not to the substantive aspects of a public health pro¬ 
gram. The agencies concerned with social insurance and assistance 
maintain their own medical and professional staffs, and make little 
use of the technical staffs of the i)ublic health agencies. ]\Iuch work 
of mutual benefit can be done cooperatively by the Public Health De- 
])artnient and the social insurance funds, esj)ecially in epidemiology, 
health education, and si)ecific ])reventive health services. A cooi)erative 
program has been attemi)ted in the field of venereal disease control 
but has not been carried over into other i)ublic health activities. 


SICKNESS FIENEFITS 

A summary of the availability of sickness benefits and disability 
records in the establishments surveyed in each of the three countries 
is shown in table 9. Some form of sickness benefits is compulsory in 
each of the three countries. As the situations differ, each country will 
be discussed sei)arately. 

(il 




Table 9 ,—Availahilily of sickness henefiis and records in all plants surveyed in Bolivia, 

Peru and Chile 


Service 

Bolivia 

Peru 

C'hile 

All es¬ 
tablish¬ 
ments 

Mining 

Alanu- 

factur- 

ing 

A11 es- 
tablish- 
ments 

Mining 

Manu¬ 

factur¬ 

ing 

All es¬ 
tablish¬ 
ments 

■ Mining 

Manu¬ 

factur¬ 

ing 

Establishments surveyed 

2.3 

/ 

' 15 

8 

21 

16 

5 

21 

8 

13 

Workers included__ 

26,488 

23,774 

2,714 

22,935 

20,530 

2,405 

46,089 

34,.5.52 

11,5.37 

■ 


Percent of workers to whom service 

is available 


Sickness benefits: 










Supplemented by: 










Management __ 




91 

96 

60 

11 


45 

Management and 










union_ _ 




4 


34 

1 


5 

Union_ _ 







40 

54 


Paid by management_ 

95 

95 

100 







Disability records kept on: 










Accidents_ 

(') 

(') 

(') 

76 

82 

25 

88 

100 

54 

Occupational illness_ 

85 

84 

100 

76 

82 

25 

87 

98 

54 

Nonoccupational illness 

8 

7 

19 

79 

82 

59 

33 

32 

36 

' 



Num 

her of plants providing service^ 



Sickness benefits: 










Supplemented by: 










Management _ 




19 

15 

4 

5 


5 

Management and 










union. __ 




1 


1 

1 


1 

Union_ 







3 

3 


Paid by management_ 

19 

11 

8 







Disability records kept on: 










Accidents.__ 

(') 

(*) 

(') 

17 

14 

3 

16 

8 

8 

Occupational illness_ 

14 

6 

8 

17 

14 

3 

15 

7 

8 

Nonoccupational illness 

3 

1 

2 

18 

14 

4 

9 

4 

5 


' Not determined. 

^ Percent not computed because of small numbers. 


Bolivia 

According to Bolivian law, owners of mines and industries who 
employ more than a specified niimher of workers must pay sickness 
benefits to their employees for nonoccupational illnesses. A worker who 
has been employed from 3 to 6 months is entitled to one-fourth of his 
pay up to a maximum of 15 days. If lie has been employed from h 
months to a year, he is entitled to half his pay for 15 days. Day 
workers employed more than a year are entitled to 1 month’s pay 
during nonoccupational disability. Salaried employees may obtain 
sickness benefits up to a maximum of 3 months’ pay, if they have been 
employed more than 1 year. Nineteen of the establishments surveyed, 
in which 95 percent of the workers Avere employed, offered these sick¬ 
ness benefits and hospitalization covering nonoccupational illness and 
accidents. 

Although 19 plants paid nonoccupational sickness benefits, only 
three plants kept records of these illnesses. There Avere, therefore, no 
accurate data available as to the extent or cost of nonoccupational 
illness. 


62 




























































Peru 

The conTpulsory social insurance scheme providing benefits for sick¬ 
ness, maternity, invalidism, old age, and death, established by law in 
Peru in 1936, is now regulated by a decree promulgated in 1941. Com¬ 
pulsory insurance applies to all persons from 14 to 60 years of age who 
habitually work for an employer and whose annual wage does not 
exceed 3,000 gold soles. Certain classes of workers, such as Govern¬ 
ment employees, are excluded from the law. The funds are made up of 
contributions from the workers (1.5 percent), employers (3.5 percent) 
and the State (1 percent). 

In order to receive sick benefits under compulsory insurance, the 
beneficiary must have paid four weekly contributions in the four 
months preceding sickness. Benefits which start from the third day 
of illness may continue for 26 weeks, and in protracted illness up to 
52 weeks. ^ledical, hospital, and limited dental services are furnished 
free. In addition, 50 percent of the average daily wage is paid as cash 
[ benefits during the first 4 weeks of illness and 40 percent thereafter. 

I The fund also provides maternity benefits and invalidism benefits when 
I the earning capacity of the worker has been reduced by two-thirds, 
i Old age and death benefits are also provided. 

' The program is administered by the National Social Insurance Fund 
and managed by an advisory board. Workers’ hospitals where treat¬ 
ment under this law may be obtained were in operation. The finest of 
these was the one in Lima which opened in 1940. This was 1 of a net¬ 
work of 12 hospitals which the social insurance fund was constructing. 
Unfortunately, several of the hospitals constructed by the Fund have 
; not been fully completed inside and lack essential equipment. As a 
' result, many workers in Peru had to put up with the inadequate serv¬ 
ices provided by some of the industrial establishments. 

All workers in the plants surveyed received sickness benefits as re¬ 
quired by law covering hospitalization, occupational and nonoccupa- 
tional illnesses, and accidents. In 15 of the mining establishments the 
workers received additional cash payments from management to sup¬ 
plement the amounts provided by the National Social Insurance Fund. 
In four manufacturing establishments supplementary sickness bene¬ 
fits were furnished by management and in one manufacturing plant 
by management and the union. 

Disability records on accidents and occupational illness were kept 
by 17 establishments, employing 76 percent of the workers. Records 
on nonoccupational illness were maintained by 18 establishments, em- 
})loying 79 j)(‘rcont of the workers. As a rule, these records were in- 
{idecpiate find did not furnish reliable data on the extent of illness 
fimong tlu* workers and their tamilies. 

Nearlv all emjiloyed jiersons in Peru come under the National Social 
Insurance Fund. Disability records, therefore, were maintained for 

63 




all of them. However, it was just as difficult to obtain nation-wide 
statistics on sickness as it was on accidents and professional diseases. 
Sufficient scattered data were obtained to indicate that sickness among 
employed persons in Peru was a real problem and one which resulted 
in large monetary losses due to absenteeism. 

One large mining concern, employing 5,000 persons, experienced 689 
cases of illness during 1^46 with a total loss of time from work of I 
6,875 days. Another large establishment, employing approximately 
2,400 persons, stated that its sickness absenteeism amounted to 2 per- I 
cent. Perhaps the best information covering the fairly large group of j 
employed persons was that obtained from the Obrero Hospital in Lima, | 
which is maintained by the Caja Nacional de Seguro Social. The | 
records of this Hospital showed that in 1946 it had 106,318 workers i 
on its beneficiary rolls. The lost time among this group for that year j 
totaled 998,960 days. This yields an average of approximately 9.4 ' 
days per person per year, a rate considerably higher than that expe- ( 
rienced in the United States, where the average days lost from just , 
sickness is about seven per person per year. j 

It, would be helpful if the National Social Insurance Fund could \ 
maintain more adequate and complete records, so that it could analyze 
its experience and, on the basis of its findings, launch a preventive 
program. Or at least it might provide leadership to help the public 
health authorities and the industries of the nation conduct such a !| 
program. ( 

Chile 

Nearly all workers in Chile are entitled to sickness insurance under ! 
the Compulsory Insurance Law. It was found, however, that sickness 
benefits required by law, Avhich entitle a worker to medical, surgical, 
pharmaceutical and dental care and hospitalization beginning with tlie 
first day of illness and lasting 26 weeks, do not entitle him to full 
weekly salary payments, except for the first week of illness. In five 
of the manufacturing plants, employing II percent of the workers, i 
cash benefits were supplemented by management; unions supplemented 
payments in three mining establishments, employing 40 percent of the 
workers; and management and the union jointly supplemented pay- | 
ments in another manufacturing plant. The amount of supplementa¬ 
tion varied—one plant added ten pesos daily to the fund, while an¬ 
other added 15 pesos daily. In one textile plant, management stated 
that it paid out 50,000 pesos annually for this purpose, while in a 
glassware plant, management made up the difference between Avhat the 
Avorkers received and his full salary. 

FiA^e manufacturing establishments ke])t no disability records. The 
other 16 establishments maintained r(‘coi’ds on accidents; 15 had 
records on occupational diseases; and 9 on nonoccupational illnesses. 
Records of nonoccupational illness Avere very meager, but they did in- 


64 






jcate a high tuberculosis rate. In general, disability records were 
either exteniji’‘ve, uniform, nor adequate. 

Fairly reliable statistics on sickness among workers can be obtained 
rom the records of the Workers’ Compulsory Insurance Fund. Vn- 
uestionably, workers’ illnesses are the most important cause of lost 
me and production. 

Data are available on 836,505 physical examinations made from 1938 
) 1945, inclusive. During these 8 years, 50,824 persons (5.9 percent) 
ere found to have tuberculosis; 55,437 (6.4 percent) had venereal 
isease; and 37,513 (4.3 percent) were suffering from cardiovascular 
iseases. In other words, about 16 j)ercent of those examined were 
iffering from these three serious conditions alone. Emphasis is placed 
1 these three diseases because the law })rovides total or ])artial ju’e- 
mtive rest with full wages for a period of time determined by the 
assibilities of reemployment for persons found to have them. Special 
edical boards determine a worker’s rights to a rest cure. 

In 1946, 1,200,000 persons were insured with this agency. Payments 
ere made for 4,500,000 days of time lost because of illness, including 
ironic illnesses which required rest cures. 

If one makes a correction for the fact that the Fumr reipiires a 4- 
ly waiting period, it is found that the average worker in diile loses 
)Out 7 days a year because of sickness. Applying this figure to the 
tal labor force in Chile, we arrive at a yearly jiroduction loss from 
ness of 12,250,000 man-days. Using the figure of 50 pesos a day which 
as emplo 3 ^ed in the discussion of accidents, we find that 612,500,000 
3SOS are lo.st ^'carl.v to the national income because of illness. Add 
• this the cost of ojierating the Fund itself, and we arrive at a 
tal annual monetary loss because of illness of 1,250,000,000 pesos, 
his figure is actualh' an underestimate, since some half million persons 
*e not insured with the Fund. If we add the monetaiy loss caused b.v 
ness to the loss ju-eviousl.v cited for accidents and jirofessional 
seases, Ave are confronted with the fact that some 2 billion ih'sos are 
st in Chile everv .vear because of disabilit.v experienced bA^ its labor 
rce. This sum represents ten percent of the present national income 
! Chile and constitutes one-third the national budget. 

It is obvious from the foregoing that time lost on the job because 
illness and accidents in (’Idle is a serious i)rol)lem from several 
)ints of A'ieAv. The task of im])roving the health status of (’Idlean 
)rkers must be attacked from two sides at once—tlirougli the Avork- 
ace and the communit3\ 




V. Current Activities 
Concerned with 
Industrial Hygiene 

In the three countries under study it was found that several office 
and nonofficial agencies have a legal responsibility or an interest in th 
field of industrial hygiene. Since any permanent industrial hygien 
and safety program that may be established should take advantage o 
every available resource in existence, the survey included a study o 
all agencies which might have some bearing on the problem. 


OFFICIAL AGENCIES 

Bolivia 

Although on May 8, 1946, the Villarroel Government promulgatei 
a decree establishing an industrial hygiene inspection service, tb 
decree was never implemented. As a matter of fact, the Governmer 
in power in March 1947, was the third Government which failed t* 
implement it. As a result, no official industrial hygiene and safety 
division existed in Bolivia at the time of the survey here reported. 

It Avas found, however, that several official agencies were engaged ii 
activities which were directly or indirectly related to industrial hygien' 
and safety. 

The activities of the following official agencies Avere studied during 
the survey: Direccion General de Sanidad (Department of Health) 
Inspeccion General de Trabajo (Department of Labor), and Caja d( 
Seguro y Ahorro Obrero (Workmen’s Compensation) all agencilJ 
Avithin the Ministerio del Trabajo, Salubridad y Prevision Socia 
(Ministry of Labor, Health and Social Welfare, later replaced by tA^ 
separate ministries) ; Direccion General de IMinas y Petroleos (De])arl' 
ment of Mines) ; and tlie Servicio Cooperative Inter-Americano dP 
Salud Pubhca (SCTSP) (Inter-American Cooperative Public llealtli 
Service). Of the agencies located Avithin the Ministerio del Tabajo. 

66 






Saliibridad y Prevision Social, and the (’aja de Seguro y Ahorro Obrero 
enjoyed ll^e greatest autonomy. 

Departineut of Health (Direccion General de Sanidad). —Bolivia is 
politically divided into nine departments, which are subdivided into 
provinces, winch, in turn, are further broken down into cantones. The 
I )(‘l)artment of lleidth, however, administered its services throup:h 12 
sanitary districts, lieadcpiarters of which were most often located in 
dei)artment capitals. Those in charge of sanitary districts directed 
public health programs through the capitals of the provinces under 
their jurisdiction. Those in charge of health programs in the provinces 
had jurisdiction, in turn, over health estal)lishments in the cantones. 

During Ihdb, the I)ei)artment of Health and its related services, 
including hospitals, employed approximately 2,()()() ]H‘rsons on a full- 
or part-time basis. This figure did not include the personnel of the 
various health missions sent into the country by the ITiited States, 
the Ivockefeller Foundation, and religious groups. 

The Department of Health encompassed several Divisions—Vital 
Statistics, Records, Technical Services, Nursing Services, Biologic 
Pi'oducts, (Iplithalmology, ]Maternal Hygiene, Sanitary Engineering, 
and Research. At the time of this survey, however, the greatest j)roof 
of* these Divisions’ existence was an organization chart. 

Idle Director (ieneral of Public Health was deeply interested in 
industrial hygiene, but the limited funds and organization at his dis- 
jHisal are not conducive to the furthering of an industrial hygiene and 
safety program. 

Department of Labor (Inspeccion General de Trahajo). —The De¬ 
partment of Ijabor included Divisions of Labor Conciliation and 
Factory Inspection. The latter function was administered through 
four geogra])hic zones. The number of factory ins]iectors emjiloyed, 
however, was far too small even to begin to cojie with factory jiroblems. 
'It is doubtful whether the staff could visit the mines and factories for 
which they were responsible once a year. The Division of Factory 
Ins])ection, like the Department of Health, has left the field of indus¬ 
trial health completely untouched, although it has concerned itself 
somewhat with the prevention of accidents. 

Worlnneirs Compensation (Caja de Sleguro // Ahorro Obrero). —The 
gov(‘rnment agency which has done most in the field of industrial 
hygiene and- safety, with the exce])tion of the SCISP (a tem])orary 
agency), is Workmen’s (’om])ensation. This agency handles the na¬ 
tional workmen’s compensation fund and workers’ savings. The agency 
has a director, a general manager, and Divisions of Safety, Adminis¬ 
tration, EngiiuMU-ing, and Economic Studies. 

In an effort to pi’otcct its funds, th»‘ Agency has att«mipted to in- 
aiigiM’alc indush-ial hygi(“ne and safety practices in those industri(‘s 
with which it dealt. Under the jurisdiction of the Medical Division, 


67 


a small group of workers concerned itself with a program for the pre¬ 
vention and control of occupational accidents and diseases. This sec¬ 
tion was staffed by a safety engineer on loan from the International 
Labour Office and a physician who had been sent to the United States 
to study industrial medicine. This small staff had instituted a pro¬ 
gram of preplacement examinations for workers, including chest X-rays 
to determine their fitness for employment in the dusty trades. The 
clinical examinations given were quite sketchy, however, and it was 
questionable whether they would yield the results desired. 

Department of Mines (Direccion General de Minas y Petroleos ).— 
The Department of Mines took no active part in insuring mine safety 
and hygiene. It concerned itself primarily with economic studies of 
mine resources in Bolivia. 

Inter-American Cooperative Public Health Service (Servicio Co¬ 
operative Inter-Americano de Salud Publica) (SCISP). —The only 
industrial hygiene and safety work of any note was that conducted 
by the Labor Section of the SCISP. Some of SCISP’s activities have 
been mentioned in an earlier section of this report. In addition, SCISP 
was attempting to strengthen the Division of Factory Inspection within 
the Department of Labor. 

Although SCISP was set up as a temporary organization, its activi¬ 
ties provide an excellent foundation for a long-range permanent indus¬ 
trial hygiene and safety program. 

This study of official agencies which might have been concerned with 
industrial hygiene revealed quite clearly that little was being done 
which might serve as a nucleus for an industrial hygiene program. 
Nevertheless, if a permanent program is to be established, there will be 
a need to coordinate all the scattered activities which are in existence, 
so that all resources may be used to advantage. 

Peru 

Although only the Ministry of Health and Social Welfare is author¬ 
ized to conduct industrial hygiene activities, other official and non¬ 
official agencies in Peru have a stake in the problem. The official 
agencies covered in th-e present inquiry were the Department of Labor 
in the Ministry of Justice and Labor, the Bureau of Mines and Petrol¬ 
eum in the Ministry of Develojnnent and Public Works, the Depart¬ 
ment of Health in the Ministry of Public Health and Social Welfare 
and the Inter-American Cooperative Health Service. 

Bureau of Mines and Petroleum. —The Bureau of IMines and Petrol¬ 
eum is charged with the prevention of accidents in mining establish¬ 
ments. Although the law under which the Bureau functions states that 
mining establishments must hire security insj)ectors and regional tech¬ 
nical delegates to make ins))ections and recommendations, the Bureau 
has one chief mine inspector and three assistants to administer the 


68 


program in the entire country. ()l)vi()iisly, this is an inadequate staff. 
Its inipotem-e is reflected in the fact that many safety liazards ^vere 
observed during this survey. 

Department of Labor. —This Dei)artment maintains a division of 
factory inspection wtiich concerns itself primarily with safety hazards, 
employment of women and minors, and workhours and wages. The 
factory inspection division maintains 21 regional offices. The l)ei)art- 
ment of Labor also handles compensation claims for occupational 
diseases and accidents. Neither this Department nor the Dureau of 
Mines concerns itself with industrial hygiene. 

Department of Health. —The Department of Health in the Ministry 
of Health and Social Welfare is a centrally organized activity. The 
author observed the work of its various divisions, particularly the work 
of such divisions as sanitary engineering, venereal disease control, 
malaria control, vital statistics, tuberculosis control, nutrition, and the 
Xational Institute of Hygiene, which operates the laboratories of the 
Health Department. All of these divisions were operating with limited 
funds and personnel, but evidenced a deej) interest in the possible in¬ 
tegration of industrial hygiene with their work. As pointed out in the 
earlier sections of this report, general jiublic health problems in the 
industries of Peru are so great that it will be essential to integrate 
industrial hygiene work Avith the other i)ublic health activities if a 
total health program is to reach all workers. This phase of the i)rogram 
will be discussed in the recommendations which will follow. 

Inter-American Cooperative Public Health Service. —ITider the 
terms of the contract between the Institute of Inter-American Affairs 
and the ^Ministry of Health and Social Welfare setting up the Servicio 
Cooperative Inter-Americano de Salud Puhlica, the work of the 
Servicio is limited to certain areas of the nation. The mining sections 
in the Central Andes and in the northern and southern sections of the 
country have not yet been touched by this cooi)erative in-ogram. The 
Servicio is badly needed in these areas in which the largest })art of 
the nation’s j)opulation lives and works. It is ho])ed that the coo])era- 
tive service will play an im])ortant role in the establishment and de¬ 
velopment of an industrial hygiene ])rogram in Peru. 


Chile 

The official agencies covered in the study Averc the ^Ministry of 
Health, Social Insurance and Social Assistance, including the Depart¬ 
ment of Health, the Workers’ Compulsory Insurance Fund, the School 
of Public Health, and the Inter-American Cooperative Public Health 
Works; the Industrial Hygiene Section of the Department of Ins])ec- 
tion in the CeiuM-al Labor Office of the Ministry of Labor; the P.ureau 
of Labor Accidents; tlic D(*partment of .Mines and Petroleum in the 
Ministry of Fconomics and (’omnierc(‘; and the Dt'Aclopmcnt ( orj)ora- 
tion. 

Off 




Department of Health .—The Department of Health in the Ministry 
of Health, Social Insurance and Social Assistance functions as a cen¬ 
trally organized activity. The divisions in this Department have been, 
created and developed in a haphazard fashion, which has often led tol 
overlapping services. The author reviewed the work of these Divisions,! 
paying particular attention to those which might be involved in ai 
complete health program for industrial workers. Among these Divi-j 
sions were Industrial Hygiene, Sanitary Engineering, Tuberculosis! 
Control, Venereal Disease Control, Health Education and Vital Statis-i 
tics. For the purpose of the present discussion, only the work of thei 
Division of Industrial Hygiene will be considered in detail. It is suf-| 
ficient to report that the heads of other Divisions were deeply interested | 
in coordinating their work with any industrial hygiene program which 
might be developed. The importance for such a coordinated approach 
in a country such as Chile, where so much public health work needs to 
be done, has already been discussed and will be treated again in the 
recommendations which follow. 

The Division of Industrial Hygiene in the Department of Health 
was organized in 1932, but until a few years ago, it was staffed by un¬ 
trained people. During the early period, the Division devoted itself 
to inspection work in Santiago and placed its main emphasis on general 
sanitation. A physician, an engineer, and chemist were trained in the 
United States during 1944-45, but since 1946 only the physician has 
been engaged in industrial hygiene work. At the present time, the 
Division consists of one physician, one engineer, one secretary, and 
one stenographer. The physician and engineer have responsibilities 
other than their industrial hygiene activities in the Department of 
Health; their salaries are derived from several sources. In addition to 
his duties in the Division, the physician works in a hospital, is re¬ 
sponsible for the industrial hygiene course at the School of Public 
Health, and has been used by the Labor Department as an impartial 
arbiter in medico-legal problems in connection with compensation 
claims; the engineer is employed in one of Sanitago’s sanitary districts. 
The present budget for the Industrial Hygiene Division is pitifully 
small; it provides the part-time salaries of the personnel listed, and a 
pittance for travel. No funds are allowed for equipment or supplies. 

With the aid of funds acquired from the Institute of Inter-American 
Affairs, the Industrial Hygiene Division has begun to establish a 
laboratory at the School of Public Health and is also acquiring chem¬ 
ical reagents needed for its work. Some equipment needed for field 
studies has also been obtained. The Division’s library is not very ex¬ 
tensive. It contains little besides books and reprints which are the 
personal property of the physician. At the Department of Health, 
the Division has two offices and no laboratory. Better facilities for the 
Division are located in the School of Public Health where tliere is an 
office for the physician and engineex% and two laboratories, 

70 



Alt(‘r unsuccrssful nitoiiipts to orj^anize a minimum staff for tlie 
Industrial Jly^imu* Division, the pliysieian has confined Ids activities 
to tlie conduct, of pr(*liminary surveys in Chile’s important industries. 
These liave Ixmmi done with the assistance of other divisions in the 
Health Department, tlie Department of ]\lines and Petroleum, the In¬ 
dustrial llyj^iene Section in the Labor Department, and other agencies. 
A report of these surveys has been presented to the Department of 
Health. Other activities of the Division have been of an epidemiological 
nature, such as a study of anthrax, an investigation of hazards in the 
hemp industry, and animal studies on carbon monoxide poisoning. 
More recently, the Industrial Hygiene Division surveyed some 400 in¬ 
dustries in Sanitary District 1 of Santiago. This survey was pre¬ 
liminary in character and served only to define the industrial hygiene 
jiroblem. In order to assist these industries with the solution of their 
problems, it will be necessary to make detailed studies of the health 
of the workers and their working environments. This can only be 
done through the activities of a comjilete industrial hygiene jirogram. 

The Industrial Hygiene Division of the De})artment of Healtli is 
res])onsible for supervising all matters relating to industrial welfare, 
investigating occiijiational diseases, and developing methods for their 
control, liecause of a lack of funds and limited personnel, these re- 
.s])onsibilities have not been fulfilled. The Division’s outstanding ac¬ 
complishment has been the definition of the industrial hygiene ])roblem 
in Chile’s industries through the conduct of preliminary surveys of 
health hazards. Since this is the first step which must be taken when 
a complete industrial hygiene program is established, the work which 
has been done so far is a step in the right direction. 

Workers' Compulsorij Insurance Fund .—No attempt will he made 
to discuss the work of the Workers’ Compulsory Insurance Fund in 
this report since a comi)reheusive article on the subject, entitled 
“Social Security in Chile,” by Wilbur J. (’ohen was published in the 
]\Iay P)47 issue of the Social Security Pulletin. The author wishes to 
|)oint out that this agency has some responsibility for industrial 
hygiene through the work of its Institute of Labor Medicine and its 
activities under the Preventive ^ledicine Law. 

Pmpiestionably, the social security laws of Chile, taken as a unit, 
constitute one of the most important pieces of social legislation enacted 
anywhere in the world. Chilean workers who are suffering from some 
form of disability are assured of adecpiate medical and hospital care 
and relief from some of their financial burdens. In this respect, 
workers in Chile are far better off than workers almost anywhere else 
in the world. 

(Tiilean industries jilace great emphasis on a worker’s welfare. Some 
of tlie larger plants offer facilities for recreation and education, and 
provide nurseries and counseling on personal problems through social 
service divisions. 


71 


It is unfortunate that Chile’s attitude toward compensating a 
worker for disability is not matched by a similar attitude toward the 
prevention of disability. With but one or two outstanding exceptions, 
this study shows that industry pays no attention to the i)reventioi] 
and control of accidents, occupational diseases, and illnesses. Ap- 
I)arently, management believes that it has done its duty when it has 
paid taxes for social security and welfare benefits. There is apparently 
little realization on the part of management that it is far cheaper in 
the long run to prevent a disability than to pay for it; workers do not 
seem to recognize that no amount of money will give them back their 
health or lost limbs. An effective and vigorously prosecuted industrial 
hygiene program is needed to prove to industry and labor that preven¬ 
tion is cheaper than compensation in the long run. 

School of Public Health. —The School of Public Health, created in 
1948, is supported by the Dei^artment of Health, the University of 
Chile, and the ilockefeller Foundation. Its erection was a project of 
the Inter-American Cooperative Public Health Works. Since its estab¬ 
lishment, the School has presented a course in industrial hygiene and 
built up its facilities in this field. Through its many contacts the’ 
School has gained the confidence and respect of industry which loolns 
to it for guidance and leadership on industrial hygiene matters. 

The School of Public Healtii is the only agency in Chile wiiicli ha« 
the trained personnel, equipment and laboratory facilities for the con¬ 
duct of an effective industrial hygiene program. While enjoying close 
working relationships with the National Hepartment of Health and 
other governmental agencies which administer social welfare laws, the 
School is able to carry on its work untrammelled by political considera¬ 
tions. h’or these reasons, the School is in an excellent position to render 
impartial fact-finding services in industrial hygiene to both industry 
and government. 

Inter-American Cooperative Public Health Works. —Since early 
1948, the Ministry of Health, Social Insurance and Social Assistance 
and the Institute of Inter-American Affairs have been o^^erating a co¬ 
operative public health program. The agreement between these two 
agencies is similar to agreements which the Institute of Inter-American 
Affairs has made with health ministries in other Hatin American 
countries. No attempt will be made to discuss the excellent work which 
this program is accomplishing in the field of public health. The sani¬ 
tation projects, health centers, and hospitals built by the Inter-Amer¬ 
ican Cooperative Public Health Works should be mentioned, however. 
The author desires to point out that the Inter-American Cooperative 
Public Health Works is in an excellent position to assume an active 
role in any industrial hygiene work which may develop in Chile. 

Labor Department.— Department of Labor has responsibility in 
the field of industrial hygiene, and in the administration of the work- 


72 



men’s compensation laws. The Industrial Hygiene Section in the De¬ 
partment of Inspection is composed of three physicians and three 
engineers. The latter operate on a regional basis—one out of Santiago, 
one out of Antofagasta, and the third out of Concepcion. This stall', 
however, is not specifically trained in industrial hygiene and has 
neither ecpiipment nor laboratory facilities for evaluating health haz¬ 
ards and devising methods of control. The services of the industrial 
hygiene i)hysieian in the Department of Health have been used to 
diagnose (piestionahle occupational disease claims. 

Bureau of Labor Accidents, —The Dnrean of Labor Accidents is a 
government-controlled insurance fund which insures workers against 
accidents and occupational diseases in Chile. The lUirean has a staff 
of eight inspectors whose duty it is to study and eliminate hazards. 
None of these inspectors has been trained. The lUirean maintains a 
Traumatological Institute, which treats injured workers and provides 
them with some vocational training after their treatment is completed. 
An educational ])rogram, designed to prevent accidents in industry, is 
also conducted by the Dureau. 

Department of Mines and Petroleum. —The Department of ]\lines 
and Petroleum functions primarily as a technical and scientific agency 
and deals with matters related to mining and allied industries. This 
Department is responsible for administering the mining code and other 
legislation which regulates working conditions in mines. The few mine 
inspectors employed by the agency do not have the technical knowledge, 
the equipment, or the facilities for conducting an effective health pro¬ 
gram in the mining industry. 

Development Corporation .—The Development Corporation of Chile 
is a government-financed organization established in H)39 to s])ur 
Chile’s industrial and economic development. The (’orporation func¬ 
tions by means of loans, capital investments, and direct operations. As 
a result of the activities of the Corporation, many new manufacturing 
industries have been develoi)ed and others have received financial suj)- 
port for expansion and modernization. The (Corporation is ])articularly 
interested in developing heavy industry in (Chile .jnd has recently as¬ 
sisted with the development of power resources and the construction 
of a steel mill. 

The Development (Corporation has an unusual opportunity to estab¬ 
lish ])rogressive and modern industrial hygiene ])rograms in those 
industries which it operates itself and to foster such programs in those 
industries which it is assisting financially. 

Overlappinp of Functions .—(Cohen, in his recent article on social 
socuritv in (Chile, ]ioints out that some 40 separate agencies administer 
social insurance laws. Although the majority of the country’s insured 
wage earners are beneficiaries of oidy five of these agencies, there is 
bound to be some duplication of effort even among these five. This 


73 


duplication of effort stems largely from the fact that there is an over¬ 
lapping of authority in the hasie laws uikN'I- which the agencies 1 unc¬ 
tion. 'ihis is especially true with regard to indiisirial hygiene activi¬ 
ties. h^or example, the IMiiiistry of Labor has the right to maintain an 
Industrial Hygiene Section within its Department of Labor while the 
Ministry of Health has authorization, for a Department of Industrial 
Hygiene in the National Department of Health. The Bureau of Labor 
Accidents is empowered to carry on an advisory industrial hygiene and 
safety program among its insured. The Workers’ Compulsory Insur¬ 
ance Fund, through its Institute of Labor Medicine, also functions in 
this field. The Department of IMines and Petroleum has responsibility 
for the health and safety of workers in mining and allied industries. 
And, finally, even the municii)alities have broad authority in many 
phases of industrial hygiene. In order to avoid some of the duplica¬ 
tion of effort present in the limited programs now in existence in these 
agencies in Chile, there is obvious need for leadership to effect coordina¬ 
tion. One of the recommendati-ons will discuss how this may be ac¬ 
complished. 


NONOIT ICIAL A(;ENC1ES 

Important resources in the develojunent of public health programs 
are the nonofficial voluntary agencies. Induslrial hygiene authorities 
have stated that the major needs fulfilled by an industrial health and 
safety program are the prevention of disability in industry through 
proper control of the working environment, medical and surgical care 
to effect promi)t restoration of health and earning capacity folloAving 
disability, and promotion of good general health among workers. It is 
obvious that voluntary organizations can help immeasurably Avith the 
fulfillment of these needs. 

For example, in the United States, the Council on Industrial Health 
of the American Medical Association has suggested activities and stand¬ 
ards for physicians who work in industry, as well as for private prac¬ 
titioners. Although it is true that the official industrial hygiene agenc}" 
can serve as a spearhead for bringing health services to Avorkers, it is 
also true that most Avorkers turn to their oAvn physicians Avhen they 
are in need of medical attention. For this reason, the Avork done by the 
Council on Industrial Health has been of great A^alue. Similarly, in¬ 
dustrial hygiene in the United States has draAvn heavily upon the 
assistance and support of agencies sponsored by management groups, 
local medical societies, universities, and, in recent years, progressive 
labor unions. 

Bolivia 

In Bolivia, no activities of the type described above Avere in progress. 
There are almost 600 physicians in Boli\da, nearly half of them in 


74 



liji Paz. Some ot Ihese pliysicians are employed fidl time by industrial 
t-oiu*erns, l)iA i(‘\v ol them have a workiii" knowledge ot* the oeciipa- 
tioiial diseases or ot* tlie i)reventive aspects of medical practice. During? 
this survey, the medical society was in i)rocess of reor'janization, and 
it was ur<j:ed that a committee on industrial health and safety be 
established. 

Manapfcment orpinizations, such as the National Chamber of Com- 
jmerce and local chambers of commerce, were also inactive in the field 
|of industrial hyjjfiene and safety. The same was true of labor unions 
I which were intensively i)reoccupied with bargaining for higher wages 
|ancl sliorter hours. Internal regulations, in effect in most industries, 

I were not used to imj)rove health and working conditions to any extent. 
I ]\Iedical, mining, and engineering schools took no active i)art in 
|training students for work in industrial hygiene and safety. 

Peru 

As in liolivia, the picture of nonofficial industrial hygiene activity in 
Peru is an impoverisluHl one. Like their Bolivian colleagues, few of 
the l.oOO phy.sicians in Bern are familiar with occupational and ]u*e- 
ventive medicine. 

In Peru there is a national Chamber of Commerce and also a 
Xatiomu ^Manufacturing As.sociation. Neither of tlie.se two management 
irroups has been active in the field of industrial hygiene. Peru also has 
a national mining as.sociation hut until now, by way of an industrial 
hygiene ]irogram, the organization has sponsored a survey by a Cana¬ 
dian mining engineer and has vigorously fought the recently enacted 
industrial hygiene law. 

Labor, too, has not shown any active interest in the field of indus¬ 
trial hygiene, except in isolated instances when labor unions demanded 
investigations of adverse working conditions. 

I iMedical and engineering schools have taken no active part in train- 
|ing students for work in industrial hygiene. 

1 Potentialities are great for a coordinated official-nonofficial attack 
ion the various industrial hygiene jirohlems of Peru, and much good 
would redound from such a concerted effort. 

Chile 

In Chile, too, there is a dearth of activity on the part of nonofficial 
agencies which should take an interest in indu.strial hygiene. Typical 
of the exi.sting ajiathy, the medical profession is poorly informed on 
occupational disea.ses. Industrial health problems are .slighted by 
manufacturers’ associations and organized labor alike. Tlie National 
Manufacturing Society of Chile and the National ^Mining Society, 
however, are definitely interested in industrial hygiene hut have not 
yet found a way to turn their interest into action. 

A National Safety Council, wliich is primarily interested in acci- 


KlsiMS—49—(1 






(lent prevention both on and off the job, has been organized in Chile 
Tlie Society issues a magazine, whicli lias published on occasion in 
formation relating to industrial hygiene and safety, but the orgnn 
ization has done little more in the realm of health and safety education 

Organized labor has not shown any jiarticular interest in indiistria 
hygiene, jiroliably because it has been too busy fighting for concessions 
such as higher wages and seniority rights. In isolated instances, labo 
unions have demanded investigations of adverse working conditions 
but because they lack an understanding of industrial hygiene and it 
implications, they have accepted slightly increased wages for thosi 
working in hazardous occupations as a satisfactory solution. No de 
mands have been made by labor unions for improvement of working 
conditions and elimination of unhealthful situations. 

The University of Chile, through its recently established School ot 
Public Health, is doing an excellent job of training physicians anc' 
other i)ublic health workers in industrial hygiene practice. The en 
gineering school has taken no active part in training engineering stii 
dents for this important activity. 

(Obviously, Chile has the resources, among its official and nonofficia 
agencies, for a coordinated attack on its many and urgent industria 
hygiene problems. What is recpured is the active leadership of a wel 
staffed and supported industrial hygiene division which can coordinati 
all tlm^ie potential resources into an integrated ])rogram. 




V[. Siiimnary 

•/ 

Tlie industrial liy^iiuie scene in liolivia, Peru, and (diile is funda- 
inentally characterized by duplication of effort and inadecpiate j^ro- 
^rainmin^ in official (piarters and apathy in nonoffieial "roups. There 
are a few overtones here and there of a real interest in industrial 
hygiene work, hut lack of funds, ])ersonnel, and knowledge of the 
modus o])erandi hinders development of this interest beyond an em¬ 
bryonic stage. 

Although the coordination of industrial hygiene activities with 
general health ])rograms is axiomatic anywhere, it is particularly 
urgent in these South American countries because of the serious 
prevalence of disease. Passive agencies must he awakened to the im¬ 
port of the problem while aware groups are galvanized into effective 
action. There is need to evoke the maximum j)otential that each agency 
can contribute and to arrange these activities in an orderly juittern 
which avoids overlai)])ing of function and cTiahles the highest degree 
of efficacy. 

P>ased upon j)ertinent observations in each country, the following 
recommendations were made to assist Polivia, Peru, and Phile in the 
develo])ment of sound, effective industrial hygiene programs. Such a 
sturdy foundation of industrial health is mandatory if these nations 
are to realize their full industrial i)otentialities. 


VII. Recommendations 


The.se recommendations were offered in an attempt to help tho.se 
officials who are interested in industrial hygiene plan and establish 
comprehensive and progressive programs in Bolivia, Pern, and Chile. 

Although the suggested organizational .structure varied in the three 
countries, the recommendation common to all was that a division of 
industrial hygiene be e.stablished, or implemented as in the case of 
Chile. This unit would then act as the keystone in the development 
of industrial hygiene programs. Based on the })remise that corrective 
mea.sures for the protection of the health of industrial workers are put 
into effect by private effort and by use of private funds, the unit’s 
most important task would be to .show industry how to solve its own 
problems. 

The types of service which the unit would render to indu.stry to 
fulfill its broad responsibilities are: (1) Evaluating industrial work¬ 
ing environments and recommending steps to be taken to correct con¬ 
ditions found to be detrimental to health; (2) Advising management 
and medical supervisors concerning the relative toxicity of materials 
or processes, giving special attention to new materials prior to their 
introduction into industry; (3) Offering consultant .services to medical 
supervisors and |)rivate physicians regarding illne.sses affecting 
workers; (4) Providing nece.ssary clinical and physical laboratory 
services; (5) Assisting management to develop, maintain, and analyze 
absenteei.sm records and health education programs; and (6) Offering 
technical guidance and advice on adult health and health education 
programs for workers. 

The nnit would also be responsible for formulating standards for 
safe practice.s and reasonable rules and regulations for the prevention 
and control of occupational diseases. The.se standards and regulations 
would be used in making reeommendations to industry regarding the 
correction of conditions inimical to health. Legal regulations, of course, 
should be resorted to only when friendly per.suasive mea.sures have 
failed, since the latter is often more successful. 

Clo.se liaison would be maintained with other agencies to avoid dupli¬ 
cation of effort and to encourage correlated, .supplemental activities. 


The unit would likewise stimulate and coordinate the work of related 
voluntary •‘agencies. 

llesponsibility for collecting and analyzing occupational disease re¬ 
ports would also rest with this unit. To ensure completeness of reports, 
the unit would have to educate physicians and industrial management 
to the importance of occupational disease reporting and to maintain 
close contact with them by investigating all cases reported promptly. 

Whenever called upon, the unit would render impartial advice to the 
W orkmen’s Compensation Agency in the settling of claims. 

Another important function of the unit would be to assume the 
leadership in encouraging .large industries to sponsor complete indus- 
! trial hygiene programs of their own. These programs should include 
I general health activities and draw upon all the health resources avail¬ 
able in the community. This expansion of industrial health programs 
into the broader field of adult health has been encouraged in the 
United States by both Federal and State industrial hygiene agencies. 
Progressive industrial management has been (piick to realize that a 
worker’s productivity is directly influenced by his general health. 

Some of the illiteracy and negligence obstacles may be surmounted 
by the formation of labor-management committees to educate and train 
the workers. This device gives the workers a sense of participation and 
was used with great success in both the United States and Great 
Britain during the war. 

One of the first educational jobs that would confront the unit, how¬ 
ever, is the development of courses of instruction for physicians, engi¬ 
neers, and nurses who wish to work in the field of industrial health. 
This project should be undertaken with the cooperation of universities 
and profe.ssional societies. 

Sufficient funds should be granted the unit to purchase the special¬ 
ized equipment needed for field and laboratory work and to set uj) and 
stock a library. To ensure the employment of properly qualified indi¬ 
viduals, a de.scription of the positions entailed in the conduct of an 
industrial hygiene program and of the requisite qualifications was pre¬ 
pared for submission to the appropriate agencies. 

^Manned by a qualified staff and equij)ped with adequate facilities, 
the unit would be in a position to chart an ambitious course, utilizing 
all existing knowledge and techniques in the promotion and preserva¬ 
tion of indu.strial health. 

The following individual recommendations are peculiar to the respec¬ 
tive situations in Bolivia, Peru, and Chile and are based upon llu' 
special needs, administrative channels, and operating facilities observed 
in those countries. 

Hnlivia 

It is recommended that the unit of industrial hygiene, j)roponnded ^ 
in the preceding section, be established as a Division of Indu.strial 

79 




Health and Safety within the new Ministry of Labor and Social Wel¬ 
fare. The Division should have complete autonomy, reporting directly 
to the Minister or a subminister. It is further recommended that the 
basic industrial health and safety law, drafted to meet Bolivia’s 
particular needs, be adopted by the Bolivian Congress as speedily as 
possible. 

In addition to miners and industrial workers, the Division’s activi¬ 
ties should embrace the uncounted thousands engaged in agricultural 
pursuits. 

The Division’s staff should include at least one physician, industrial 
hygiene engineer, safety engineer, and clerk, all members functioning 
as a team. The duties and functions of the Division have been dis¬ 
cussed in the foregoing description of the industrial hygiene unit’s 
responsibilities. 

It is also recommended that the Minister of Labor and Social Wel¬ 
fare appoint an Advisory Committee to the Division of Industrial 
Health and Safety. The Committee should be made up of representa- 
lives' of the IMinistry of Hygiene and Health, the Workmen’s Com¬ 
pensation Agency, the Bolivian Medical Society, industrial manage¬ 
ment and organized labor. The function of the Committee would be 
to advise the Division on matters of policy and operation. 

It is recommended, too, that the occupational disease compensation 
law now in effect in Bolivia be revised. Diseases which are not occu¬ 
pational in origin, such as tuberculosis and nephritis, should not be 
compensable. Provision for compensation for partial disability from 
silicosis should be eliminated. Compensation funds saved by these 
changes should be used to support a vigorous program of prevention 
and health education for industrial workers. 

Legislation to prohibit child labor should be adopted by the Bolivian 
Congress as speedily as possible. At the same time, educational facili¬ 
ties should be improved so that the growing generation will be able to 
take advantage of a health education program. 

To furnish experienced leadership to the pro])osed Division of Indus¬ 
trial Health and Safety in the launching of its program, it is recom¬ 
mended that a consultant in industrial hygiene and safety be attached 
to the SCISP for several years after the scheduled termination of the 
labor program. 

Peru 

On March 12, 1947, a law was enacted creating a Department of In¬ 
dustrial Hygiene in the IMinistry of Public Health and Social Welfare, 
whose function is the prevention of ])rofessional disease's—the ])neumo- 
conioses, in particular. It is recommended that the activities of this 
Department be administered under the direction of* the (SCdSIO^ 
Servicio Cooperativo Inter-Americano de Salud Publica. Directed by 
trained and well-qualified personnel, the Servicio has demonstrated its 



ability and usefulness in administerin" a public health ])ro"ram in Peru. 

The service's of a physician and a chemist from the Ibiited States 
>hould be added to this program as soon as possible to supplement the 
work of the engineer already assigned by the Institute of Inter- 
American Affairs. Necessary field and laboratory ecpiipment should be 
obtained immediately to permit prompt operation. 

The industrial hygiene program should start as soon as is practicable 
in the region of Cerro de Pasco, with headquarters in the town of Cerro 
(le Pasco, the center of the most important mining area in the Central 
Andes. This field office shoidd be equipped for the conduct of physical 
examinations, as required by the new law, and for the activities of an 
engineer. 

Field centers should later be established in La Oroya, iMorococha, 
and Lima. Each field office should be staffed with a physician trained 
in silicosis techniques, an X-ray technician, an engineer, and a clerk. 
The necessary apparatus for conducting physical examinations, in¬ 
cluding X-rays of the chest, and field and laboratory ai)paratus for the 
engineer, will also be needed. The Lima office should have portable 
X-ray and other equipment for conducting physical examinations in 
the Southern mining area. 

The Department’s chemical laboratory should be located in Lima. 

Personnel, both medical and engineering, should be selected as speedi¬ 
ly as possible and sent to the United States for training. The physician 
now studying at Harvard should si)end at least ‘1 months studying 
silicosis at the Saranac Laboratory for the Study of Tuberculosis 
before he returns to Peru. In order to initiate the program of physical 
examinations at once, a physician should be employed immediately. (It 
is understood that a Peruvian physician will be immediateh; assigned 
to this program from the Servicio Uooperativo Inter-Americano de 
Salud Publica and will receive his training in Peru. A Peruvian 
chemical engineer has already been selected and engaged to work under 
the engineer now assigned to the program by the Institute of Int(*i- 
American Affairs.) 

It is also recommended that the President of the Republic of Peiui 
appoint an advisory committee to the Department of Industrial 
Hygiene. The committee should be made up of representatives of tin* 
Ministry of Justice and Labor, the Alinistry of Development and Publie 
Works, the Alinistry of Public Health and Social Welfare, the Peruvian 
medical .society, industrial management, and organized labor. The com¬ 
mittee should advi.se the Department on matters of policy and operation. 

As provided by law, the scope of the Dcqiartment’s activities should 
he extended at the end of 2 years of operation to include all the indus- 
tri(*s of P(*ru. S(*rviees should also lx* available to tlx* more* than 
1,0()0,()()() agricultural workers. 

In order to assure the new Department of Indu.strial Hygiene eom- 


81 




petent guidance during the period immediately following its organiz 
tion, the program should be administered by the Servicio Cooperati 
Inter-Americano de Salud Publica for at least the next 2 years. Ste' 
should be taken to include an industrial hygiene program among t; 
cooperative activities carried on by the Institute of Inter-Americc! 
Affairs and the Ministry of Public Health and Social Welfare of Peri 

Chile 

Since the School of Public Health possesses superior operating f 
cilities and enjoys political freedom and public confidence, it is recoi 
mended that an Institute of Industrial Hygiene be created within th 
State institution. 

Approximately 1,250,000 pesos a year will be needed to carry on 
minimum program in industrial hygiene. This sum might well I 
obtained from those sources which would benefit most from such a pr 
gram, namely, labor, industry, and government. 

As a minimal staff, the Institute should have a physician directo 
an engineer, a chemist, a clerk and a laboratory assistant. For the fir 
several years, the program should be based in Santiago. It is recon 
mended, however, that at a later date branch offices be established i 
Antofagasta and Concepcion to serve the northern and southern zones 

There is now in Chile a nucleus of personnel trained for the condin 
of industrial hygiene activities. In order to interest these people i 
joining the Institute of Industrial Hygiene, it is essential that positioi 
in the Institute be set up as full-time, permanent, well-paying posts. 

As in the case of Bolivia and Peru, it is recommended that the Pres 
dent of Chile appoint an advisory committee to the Institute of Indii 
trial Hygiene, composed of representative members. 

Consideration should be given to strengthening the Preventive Med 
cine Law of Chile so that annual physical examinations may be bett( 
employed in the interest of improving workers’ health. This laAV shoul 
also be revised so that the preemployment examinations now given ca 
be more fully utilized as placement guides. 

Because of Aveaknesses in the Avorkmen’s compensation legislatioi 
it is recommended that a Presidential committee be appointed to stud 
the laAv and suggest corrective changes in its content and administratioi 

Finally, in order to coordinate the actiAuties of all the participant 
in the proposed program, it is recommended that an experienced techi 
nician from the United States be employed for a period of 1 to 2 year.-i 


82 



AI’I’KNDIX I — INDUSTRIAL HYGIENE SURVEY — GENERAL DATA 


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83 







































































































































INDUSTRIAL HYGIENE SURVEY—EXPOSURE DATA 


Date ' 


Name of establishment: - 

Raw materials: - 

Products:- 

Processes:- 

Exposures: lOstimate number exposed 

Dusts: - 

Type: - 

Control measures: - 


Fumes and gases: _ 

Type: __ 

Control measures: 


Special poisons:- 

Type: - 

Control measures: 


Temperature extremes: 
Control measures: — 


Ventilation:. 
Type: _ — 
Adecpiacy: 


Other notes: 

































Appendix II 


ORGANIZATION OF THE DEPARTMENT OF 
INDUSTRIAL HYGIENE IN THE MINISTRY 
OF PUBLIC HEALTH 


Law No. 10833 


! The President of the Republic : 

' Whereas: 

, Congress has enacted the following Law : 
j Congress of the Peruvian Republic : 

Has enacted the following Law : 

Article 1 .—The Department of Industrial Hygiene in the Ministry of 
j Public Health and Social Welfare shall begin work regarding preven- 
i tion and attendance of professional diseases, especially the pneumo- 
; conioses. 

Article 2 .—Work stated in Article 1 shall include, besides work 
specified by the Executive Power in later dispositions and regulations, 
-the following: 

i {a) Clinical and radiographic examination of candidates for mining 
work and the same examination, i)eriodically done, on workmen per¬ 


forming such work; 

{h) Medical examinations, re(iuested by the Pneumoconiosis Expert 
Board; 

(c) Medical control of individuals suffering from i)neumoconiosis or 
other professional diseases, who continue working; 

{(1) Periodic inspection of mines and plants of the industry itself 
for dust control. This work shall include the samioling and analysis of 
[lusts in suspension, smoke, gases, acids and other noxious substances; 

{e) Planning and application of ventilating systems and methods 
for tlie mines and working i)laces; 

(/) Investigations regarding suitability of installation of api)aratus 
find dust removal e(piii)ment and use of given tyi)es of proteetive masks; 

{{]) Investigations regarding suitability of establishing plants for 
administration of aluminum powder with i)reventive and welfare pur- 


85 





poses; and medical control of healthy or ailing individuals, subjected to 
this process in plants to be established as a result of such investigations 
or by private initiative of companies; 1 

(/i) Educational work among the administrative and labor staff of| 
mining companies with purpose of demonstrating usefulness of pre-l 
ventive measures and insuring cooperation to be given for fulfillment 
thereof; and, ' 

(i) Incorporation of all measures connected with this problem in 
future. 

Article 3 .—The Department of Industrial Hygiene shall graduallyi 
extend its action to all mining centers of the country, but shall begin! 
operations in the region including the Departments of Lima, Ica,; 
Junin, Pasco, Huanuco, and Huancavelica. | 

To duly fulfill its mission and after the necessary studies, it shallj 
establish a Central Office and Departmental Offices in principal mining 
regions, said offices to include administrative sections and medical and' 
engineering laboratories, as well as portable equipment, which may be! 
necessary. 

Article 4 .—The operation of the Department of Industrial Hygiene, 
in connection with the mining industry and allied industries, shall be' 
maintained by those companies occupying over 30 laborers, by a con-, 
tribution of 1.8 percent on the total amount of payrolls. 

The designation ‘‘mining company” is understood to include indi¬ 
vidual or collective persons performing work for making use of any 
mineral substance and soils, rocks, clays, sands, gravels, and cements, 
as well as all industrial processes related to the preparation and use of 
such substances. 

There are included in the computation of the tax salaries of all 
employed in those industries, under the direct dependency of said indi¬ 
vidual or collective persons or of contractors and middlemen, without 
any exception whatsoever. 

Article 5 .—The contribution established in Article 4 shall begin to 
govern within 30 days of the promulgation of the present law, in the 
Departments of Lima, Ica, Junin, Pasco, Huanuco, and Huancavelica. 
The same contribution shall be applied, successively and with approval 
of the Executive Power, to other districts, when the organization of the 
Department of Industrial Hygiene extends thereto. 

Article 6 .—Companies may not deduct directly or indirectly, the 
amount of the contribution created by this law, from the salaries or 
other remunerations paid to their employees. 

Article 7.—A Board of Vigilance and Economic Control, formed by 
representatives of the Executive Power and of the industries contrib¬ 
uting to the support thereof, the number whereof shall be determined 
by the Government, shall control the economic progress of the Depart¬ 
ment of Industrial Hygiene and the investment of its income for the 
purposes specified in the present law. 


86 



Article 8. —After a period of two years, to be counted from the date 
on wluc'li tlm Department of Industrial llyj^iene ])e‘j:ins its duties, the 
Government shall make up another taxation plan, based on the degree 
of danger of tlie work in each mining enterprise and the number and 
I source of the cases of professional disease. 

The National Bureau of Social Insurance shall i)roceed to effect the 
necessary mathematical calculations and within the maximum period 
of two years, from date of promulgation of the present law, shall estab- 
I lish an insurance for professional diseases, to include the granting of 
I an income to ailing individuals, with partial or total disability, tem¬ 
porary or permanent, which may have been established by the Pneumo- 
I eoniosis Board of Experts. Said insurance shall include nursing bene¬ 
fits available in hospitals and other dependencies of the National Bureau 
I of Social Insurance. 

I In the making up of the new taxation plan and establishment of the 
i insurance, referred to in this Article, the information resulting from 
! the studies performed by the Department of Indu.strial Hygiene shall 
be used. 

Article 9. —The Minister of Public Health and Social Welfare shall 
make up, within a maximum period of 60 days from the date of promul- 
I gation of this law, the necessary drafts for the organization and regu¬ 
lation of the services created thereby, the technical training of its per¬ 
sonnel, and those necessary for the coordination of the work effected by 
other Government Departments. 

Article 10. —Laws and dispositions insofar as opposed to the present 
law are hereby repealed. 

Let this be transmitted to the Executive Power for promulgation. 

Congress House, in Lima at ten days of the month of March, nineteen 
fortv-seven. 

(Sgd.) 

Jose Gaevez, President of the Chamber of Senators. 

Pedro E. ]\Iuniz, President of the Chamber of Deputies. 

L. F. Ganoza, Senator Secretary. 

A. Haya de la Torre, Deputy Secretary. 

Therefore: I order this to be published and complied with. 

Given in Government House in Lima, at twelve days of the month of 
March, nineteen forty-seven. 

(Sgd.) 


J. L. Bustamante. 
Alberto Hortado. 


1 


87 


Appendix III 



SUGGESTED RULES AND RE(;ULATIONS FOR THE ^ 

PREVENTION AND CONTROL OF OCCUPATIONAL DISEASES AND j 
A DISCUSSION OF CURRENT PRACTICES FOR COMPLIANCE [ 
WITH SUCH RULES AND REGULATIONS 


J. J. Bloomfield, Sanitary Engineer Director, Assistant Chief, 
Division of Industrial Hygiene, Vublic Health Service 


and 

Bernahd I). Tebbens, Industrial Hygiene and 
Safety Engineer, Institute of 
Inter-American Affairs 



JUNE 1947 







Foreword 


One of the major causes of lost time in industry is workers’ ill health, 
some of it caused hy ])hysical conditions in the jol) environment. 
Although industrial hygienists now have the tcchni(jucs to prevent 
almost any kind of occupational disease, unfortunately the application 
of this knowledge has not progressed as rapidly as it lias been accjuired. 
The problem, then, is the promotion of industrial hygiene tecliniipies so 
that they reach every industry. 

One effective means of disseminating and applying information on 
good industrial hygiene ])ractice has been tlirough the promulgation 
and administration of reasonable rules and regulations designed to set 
forth systematically the principles involved in such ])ractices. Such 
rules and regulations, or codes, as they are sometimes called, can be of 
significant aid to industry in achieving safe and healthful working con¬ 
ditions, if they are based on scientific fact, are jiractical and adeipiate. 

In our oi)iniou, the main purpose of a code is to ])rovide information 
which would enable industry to maintain the health of its workers at a 
high level. If a code is to accomplish this juirpose, it must also he 
reconciled Avith the chief aim of industry, which is to turn out goods 
and services in the most efficient Avay possible so as to achieve maximum 
production at minimum cost. To accomplish all this, a code should con¬ 
tain not only rules and regulations for the prevention and control of 
occui)ational diseases, but also an informative discussion of the best 
j)ractices in industrial hygiene, which would indicate to management 
and labor just how compliance with the rules may he achieved. Oidy 
the rules and regulations of such a code should be mandatory. 

At the present time, there is a great deal of activity in the United 
States and in other countries in the development of rules and regula¬ 
tions, or code.s, for the prevention and control of occui)ational diseases. 
For the most part, this activity has been stimulated by legislation whicli 
j)laces certain responsibilities on industrial hygiene divisions for the 
promulgation and enforcement of rules and regulations. In the United 
States, where each State is more or less autonomous, one finds a diversity 
of laws and codes, not only as to content, but also as to administration. 
Such a state of affairs makes it extremely difficult for large industrial 
concerns, which operate in several States, to set a definite policy for the 


89 


maintenance of healthful conditions in their industries. For this rea¬ 
son, several national agencies have been attempting to develop codes of 
a general basic character which could be adopted by all the States in 
the interest of uniformity of content and administration. 

The Institute of Inter-American Affairs has had a cooperative pro¬ 
gram with the government of Bolivia on health and sanitation problems. 
Part of this program has been concerned with working conditions among 
Bolivian industrial workers, and particularly the workers in the mines 
of that country. It is not the purpose of the present discussion to go 
into detail regarding the joint labor program in Bolivia with which 
both authors have been identified, except to indicate that one of the 
objectives of this labor program was the development of a practical 
code designed to prevent and control occupational diseases. 

The rules and regulations which follow, as well as the current prac¬ 
tices for compliance with these rules and regulations, are based, for the 
most part, on the material prepared for the use of the Bolivian 
government. 

These rules and regulations have certain unique features which will 
))ecome obvious to the reader, and which we feel merit serious con¬ 
sideration not only by management and labor, but also by governmental 
administrative agencies which have the responsibility for industrial 
hygiene work. As a matter of fact, the section dealing with current 
practices for compliance with the suggested rules and regulations is in 
itself a novel feature in codes of this type. Although the current prac¬ 
tices discussed herein for the attainment of healthful working condi¬ 
tions could be presented in greater detail, we do feel that in its present 
brief form it contains sufficient information to be of aid to industry in 
attempting to comply with the rules and regulations. 

It is our desire to emphasize the need for a realistic approach to this 
whole subject. We feel that there is a definite responsibility upon gov¬ 
ernmental agencies administering industrial hygiene to implement 
rules and regulations for the prevention and control of occupational 
diseases in a practical and impartial manner. It seems to us that before 
an industry is told that it should make certain provisions to control a 
condition suspected of being inimical to health, a complete health sur¬ 
vey is in order. Such a health survey should involve at least two cri¬ 
teria in determining the safety of an operation. First, it is essential 
that the health of those workers exposed to a certain material or con¬ 
dition should be carefully inquired into. This may involve not only 
an examination of the worker’s health record, but also an examination 
of the worker himself. Second, careful environmental studies should be 
made, which would include not only certain determinations of the 
atmosphere, but also a thorough sanitary survey and occupational 
analysis. All these put together should yield data of real value in help¬ 
ing to control industrial health hazards. 


90 


It is lio])ecl that the material ^vhich follows will be given serious con¬ 
sideration hy management, labor, and those governmental agencies re- 
s})onsihle for industrial hygiene administration. All three grou])s have 
a large stake in the maintenance of industrial health. All that is needed 
to assure the success of basic rules and regulations such as those sug¬ 
gested in this paper is that they he administered in a spirit of coopera¬ 
tion with management and with labor. 


SI kules and kegulations for the 

PREVENTION AND CONTROL OF 
OCCCPATIONAL DISEASES 


I. Iiitrodiirtioii 


A. Authority 

This code has been adopted hy the . of the 

.in the discharge of its duties under the authori¬ 
ty granted hy the. 

15. Purpose 

The purpose of this code is to ])rescrihe minimum recpurenients for 
the prevention and control of occupational diseases, to advance the 
workers’ health, and to furnish information for the use of management 
and emi)loyees in attaining these objectives. 

C. Application 

The provisions of this code shall apply to all mines, factories, con¬ 
struction projects, service industries, and other places of employment. 
The ])rovisions of this code are limited to the prevention and control 
of occupational diseases and do not abrogate e.xisting codes, nor pre¬ 
vent the adoi)tion of future codes, dealing with general sanitation of 
work places. 

I). Adniiuistratiou 

This code will he enforced hy the . of the 


K. Appeal for Modification 

When strict compliance with the i)rovisions of the code involves 

undue hardship, the . may, ui)on a])plication in 

writing, j)ermit modification of the re(piirements when other means 
of ecpiivalent i)rotection are i)rovided. Any modification granted under 
818948 — 49—7 








the provisions of this paragraph shall be limited to the particular cas( 
covered in the application of appeal for modification. 

F. Penalties ■ 

Any person, firm, or corporation failing or neglecting to comph 
with any rule or regulation of this code shall under the powers con j 

ferred by.be guilty of a misdemeanor, and upor 

conviction shall be fined in accordance with the provisions of the abov( 
law. 

G. JJnconstitutionality Clause 

Should any section, paragraph, sentence or clause, or phrase of thh 
code be declared unconstitutional or invalid for any reason, the re¬ 
mainder of said code shall not be affected thereby. 

H. Repeal and Date of Effect 

All codes and parts of codes in conflict with this code are hereby' 
repealed, and this code shall be in full force and effect immediately 
upon its adoption and its publication as provided by law. 

I. Definitions 

(1) A ‘'health hazard” shall be interpreted to exist when exposurel 

to any contaminant or condition encountered in the environment isj 
sufficient to injure any part of the body or reduce in efficiency the! 
normal function of any part of the body. • 

(2) "Ventilation” is the process of supplying or removing air by 
natural or mechanical means to or from any space. 

(3) "General Ventilation” means that type of ventilation in which 
air is supplied to or removed from anj- area. 

(4) "Natural Ventilation” means ventilation which depends upon 
natural air currents to i)rovide air movement in the environmental area. 

(5) ''Mechanical Ventilation’’ means ventilation which depends upon 
the operation of power driven equipment to remove air from or deliver 
air to the desired location or area. 

(6) "Local Exhaust Ventilation” means that type of ventilation in 
which dusts, fumes, vapors, gases, and mists are removed from the 
atmosphere near the sources of their generation. 

(7) "Dusts” are solid particles generated by handling, crushing, 
grinding, rapid impact, detonation and decrepitation of organic or 
inorganic materials, such as rock, ore, metal, coal, wood, grain, etc. 
Dusts do not tend to flocculate except under electrostatic forces; they 
do not diffuse in air but settle under the influence of gravity. 

(8) "Fumes” are solid particles generated by condensation from the 
gaseous state, generally after volatilization from molten metals, etc., 


92 





and often accompanied by a chemical reaction such as oxidation. Fumes 
Hocculate and sometimes coalesce. 

(D) Allots are sus[)ende(l licpiid droplets gem*ratt‘d by condensa¬ 
tion trom the piseous to the liipiid state or by breakin*’: u}) a li(jiiid into 
a dispersed state, such as by splashinj;. foamiuj;, and atomiziii". 

(10) ‘ Vapors’’ are the gaseous form of substance which are nor¬ 
mally in the solid or licpiid state and which can be changed to thes(‘ 
states either by increasing the pressure or decreasing the temperature 
alone. V^apors diffuse. 

(11) “Gases” are normally formless fluids which occupy the space 
of enclosure and which can be changed to the liciuid or solid state only 
by the combined effect of increased pressure and decreased tempera¬ 
ture. Gases diffuse. 

(12) “Healthful and Comfortable Environment” means atmosphere 
having an effective temi)eratur(‘ as near the comfort level as good in¬ 
dustrial hygiene engineering practices will permit and never at a level 
at which injury to health will result. This does not apply to environ¬ 
ments where abnormal temperature and/or humidities are encountereil 
through the inherent nature of the ])rocess and wliere individual pro¬ 
tection is given through clothing, supplied air, or other means. 

(13) “Abnormal Atmospheric Pressures” means atmosi)heric ])res- 
sures which when suddenly adjusted to normal atmospheric i)ressur(‘. 
may produce injury to workers occupying that area. 

(14) “Sanitary Condition” means physical condition of working 
environments such as will tend to ])revent the incidence and si)read of 
disease. 

(15) “Contaminant” means an undesirable substance or material. 

(16) “An Infectious Agent” is a pathogenic microorganism which 
is capable of ])roducing disease by entrance into and by multii)lication 
within the body. 

(17) “Protective Ecpiipment” is a device, a permanent installation, 
clothing or other means for the adecpiate protection of the worker 
against health and safety hazards. 

(18) Th(‘ word “shall” where used is to he understood as mandatory. 

II. Kiiles 

A. (General Provisions 

1. Records. —Every employer shall maintain ade(iuate records of 
occupational di.seases and other disabling illnesses which occur among 
his employees. In those establishments employing 50 or more i)ersons, 
these records shall be tabulated and analyzed by the emi)loyer, and a 
statistical summary of the causes of disability shall he furnished at the 
end of each (piarter to the . (piarlerly sta¬ 

tistical summary shall be prepared on forms furnished to the emi)loyer 
by the. 


93 




2. Employer Responsibility.— (a) Every employer shall comply 
with the various laws pertaining to the control of industrial healtl] 
hazards and shall maintain a healthful jilace of employment. 

(6) Every employer shall determine the health hazards in his plac( 
of employment by means of a surveys of his establishment. j 

(c) Every employer shall instruct his employees regarding tin 

hazards to which they are exposed and, the methods which have beer 
taken for the prevention and control of such hazards. In all wort 
places where special hazards to health exist, employers shall post i 
notice of such hazards in a prominent position in the work place, noti 
fying the workers of the hazard and the means for safeguarding againsi' 
it. I 

(d) Every employer shall install or provide adequate protectiv(|^ 
equipment for the prevention and control of occupational diseases and 
shall maintain such equipment at its highest efficiency and in a sanitary 
condition. 

3. Employee Responsibility. — (a) Every employee shall use the*' 
protective equipment provided by the employer for the prevention and^ 
control of occupational diseases. 

(h) Employees shall not abuse or mishandle in any manner equip^ 
ment provided by the employer for the workers’ protection against 
health hazards. ^ 

(c) Every employee shall comply with all healthful practices agreed 
upon between the employer and the employee organization. * II 

4. Labor-Management Committees. —In all establishments having: 

50 or more employees, there shall be allowed the formation of a joint' 
committee of equal representation from employer and employee groups? 
for the exclusive purpose of health maintenance. ^ 

5. Notification of the Creation of New Establishments, Proc-|( 
ESSES OR Changes of Processes.—E very employer shall notify^ tlie; 

. within 10 days of the establishment of a new 

enterprise, process, or change in process, and whenever practicablei 

shall furnish the . with plans and specifications: 

of such new or changed process. , ! 

B. Environmental Conditions 

1. General. —There shall not exist in any place of employment any 

process, material or condition known to have an adverse effect on health' 
unless provisions are present to maintain the occupational environment 
in such a state as to prevent the existence of a health hazard. 1 

2. Maximum Allowable Concentrations for Atmospheric Con-' 

TAMINANTS. —There shall not be used any process or material which will 
liberate any contaminant into the atmosphere of occupied area.^ unless' 
arrangements are present to prevent the contaminant from injuring 
any part of the body, or reducing in efficiencv the normal function of 
any part of the body. . 


94 





The maximum allowable concentration for atmospheric contaminants 
in occupied areas should include, but is not restricted to, the following 
substances and their corresponding: maximum allowable concentration 
values: 


MAXIMUM ALLOW ABLE CONCENTRATIONS 

Gases and Vapors 

(Parts per million) 


Substance 

Acetone - 

I Acrolein- 

I Ammonia- 

; Amyl acetate_ 

Aniline - 

Arsine- 

Benzene_ 

Carbon disulfide_ 

Carbon monoxide __ 
Carbon tetraeldoride 

Chlorine_ 

Ethyl ether- 

j Formaldehyde_ 

f Gasoline_ 

Hydrogen chloride 
Hydrogen cyanide . 
I Hydrogen fluoride 
^Hydrogen sulfide--. 

Methanol_ 

Naphtha (coal tar) 

‘ Nitrogen oxides --. 

Nitroglycerine _ 

Phosgene_ 

Stibine_ 

Sulfur dioxide- 

Trichlorethylene_ 

Toluene - 


Concentration 

500 

0.5 

100 

200 

5 

0.05 

‘)5 

20 

100 

50 

1 

400 

5 

500 

5 

10 
• > 

20 

200 

200 

25 

0.5 

1 

0.1 

10 

100 

200 


Toxic* Dusts, Eiinies and Mists 

(Milliprams per cubic meter) 

i^ubstance 

Antimony _ 

Ars<‘nic _ 

Cadmium - 

'’hromic acid- 

bead _ 

Hercury_■'- 

Zinc oxide_ 


Concent ration 

0.5 

0.5 

0.1 

0.1 

0.15 

0.1 

15 


95 









































Mineral Dusts 

(Million particles per cubic foot) 


Substance Concentration 

Asbestos_j_ 5 

Silica (more than 70%)_ 5 

Silica (40% to 70%)_ 10 

Siiica ( 5% to 40%)___ 20 

All (lusts (less than 5^ silica)_ _ 50 


Radiation 

X-rays- 0.1 roentgen unit per 8 hour exposure 

3. Skin Contact with Hazardous Materials. —Where the sub¬ 
stances encountered are capable of causing any pathological change in 
the skin, adequate precautions shall be taken to prevent these sub¬ 
stances from contacting the skin. 

Where the substances encountered are capable of being absorbed 
through the skin or mucous membrane thereby producing injury to 
health, adequate precautions shall be taken to prevent these substances, 
from contacting the skin and/or the mucous membrane. 

4. Infectious Agents. —There shall not exist in any occupied area 
any processed or unprocessed material containing infectious agents un¬ 
less provisions are present to prevent the infectious agents from injur¬ 
ing any part of the body. 

5. Illumination. —The quality and quantity of illumination in any 
occupied area shall be adequate to permit the performance of all neces¬ 
sary work in a safe manner and without injury to the eyes. 

6. Temperature, Humidity, and Air Movement. —Natural or me¬ 
chanical ventilation shall be provided in all occupied areas to insure a 
healthful and, so far as feasible, a comfortable environment as regard 
to temperature, humidity, heat radiation and air movement. 

7. Noise. —There shall not exist in any occupied area any process or 
operation producing noise unless provisions are present to prevent the 
noise from injuring any part of the body or reducing in efficiency the 
normal function of any part of the body. 

8. Vibration. —Wherever any process or operation producing vibra¬ 
tion is conducted in any occupied area, provisions shall be present to 
prevent the vibration from injuring any part of the body or reducing 
in efficiency the normal functions of any part of the body. 

9. Pressure. —In occupied areas where the workers are subjected to 
abnormal atmospheric pressures, provisions shall be present to prevent 
injury to any part of the body of the worker upon entering, working 
in, or leaving that area. 

10. Radiant Energy. —Wherever any type of radiant energy is 
emitted into an occupied area, provisions shall be present to prevent 


96 








tnese radiations from injuring any part of the body or reducing in 
efficiency the normal functions of any part of the body. 

11. ^ ENTiLATiox.—Where excessive amounts of contaminants may 
be liberated into the atmosphere of occupied areas, ade(iuate ventilation 
systems for their removal shall be installed, maintained in good condi¬ 
tion, and operated efficiently at all times vhen work is being done. 

The discharged air of a ventilating system shall not be permitted to 
re-enter the same or other working areas and shall not constitute a 
health hazard or nuisance in the community. 

Plans and specifications for all ventilating systems shall be submitted 
to the.for approval prior to their installation. 

12. Respiratory Protective Equipment. —When exposures to exces¬ 

sive amounts of atmosjiheric contaminants are intermittent and of brief 
duration, or where ventilation or other control methods are impractical, 
the workers shall be protected by means of resihratory protective 
equipment. Such eipiipment shall give adecpiate protection against the 
specific contaminant under the conditions encountered and shall be of a 
type approved by the. 

Respiratory protective eipiipment shall be employed only under the 
conditions above stated and shall not be used in lieu of other, control 
methods of a more effective and ])ermanent character. 

13. Personal and Protective Clothing and Equiilment. —Workers 

in operations, processes or conditions of work which unduly expose 
them to dampness and wet environments, excessive heat, excessive noise, 
hazardous radiations, and other eye hazards, skin irritants, falls, fall¬ 
ing material and other hazards, shall be provided with proper protec¬ 
tive clothing and other devices of a ty]ie approved by the. 

14. Housekeeping. —The housekeeping in all occujiied areas shall 
be such as to promote a healthful environment. 

15. Sanitation. —The sanitation within all places of ein])loyment 
shall be such as to promote a healthful environment. No insanitary 
condition shall exist which may increase the incidence or permit the 
spread of disease. The handling, ]n*eparation and serving of food and 
drink shall be conducted in such a manner as to ])revent the spread of 
disease. 

C. Mediral Provisitnis 

1. Prevention and Treatment of Occupational Illnesses and 
Injuries. —Arrangements for facilities and services shall be ])resent 
for the jn-evention and the ])rompt and early treatment of all illnes.ses 
and injuries resulting from occu])ational exiiosures. 

2. Prevention and Treatment of Xonocvupational Illnesses 
AND Injuries.— Arrangements for facilities and services shall be jiresent 
for the prevention and the prom])t and early treatment of all emer¬ 
gency nonoccupational illnesses and injuries. 


97 








3. Physical Examinations. —Every employer shall maKe available 
at no cost to a prospective worker a preplacement health examination. 

Periodic health examinations shall be given to all workers requesting 
such examinations at no cost to the worker. In the case of workers* 
exposed to toxic materials or hazardous conditions of work, such asi, 
those exposed to siliceous dusts, heavy metal dusts, or toxic solvents,;: 
the workers shall be examined as often as deemed necessary by the’ 
examining physician, but such examination must be given at least once: 
a year. 

In case the periodic examination shows the worker unfit for further : 
work or for certain classes of work, thereby barring the worker’s future 
employment, then the latter may designate a physician of his choice 
and request a review of the findings. If the two physicians cannot agree 
on the findings, then a third physician, agreed on by the two physicians,' 
shall be selected and his findings shall be final. If the two physicians: 

cannot agree on a third physician, then director of the. 

.shall make the selection. 


CURRENT PRACTICES FOR COMPLIANCE WITH 
SUGGESTED RULES AND REGULATIONS FOR 
THE PREVENTION AND CONTROL 
OF OCCUPATIONAL DISEASES 

A. General Provisions 

1. Records 

Rule. Every emjdoyer shall maintain adequate records of occupa- ; 
tional diseases and other disahling illnesses which occur among his em¬ 
ployees. In those establish ments employing 50 or more persons these 
records shall be tabulated and analyzed by the employer, and a statis¬ 
tical summary of the cases of disability shall be furnished at the end of 

each quarter to the ... This quarterly statistical ' 

summary shall be prejMired on forms furnished to the employer by the : 

Purpose of Rule. —In order to control and prevent disability among 
workers, it is necessary to determine where, Avhen, and under what 
conditions absenteeism from disability is occurring. 

Practices for Compliance with Rule. —Some plants will find it 
impracticable at the outset to collect data on absences of all durations > 
and for all causes. As a minimum it is recommended that data on ^ 
absences lasting eight consecutive calender days or longer be collected i] 
and that the reasons for absence be confined to sickness and nonindus- i 
trial injuries. However, as soon as an industry has had some experience C 


98 









^^ith regarc* to this type of statistics, it should give serious considera¬ 
tion to include absences of shorter duration and from all reasons. 

In tlie ease ot industrial injuries and occupational diseases, records 
shall be kept on all disabilities resulting in loss of one or more work 
shifts. 

Regardless of the length of the absence and the reason for it, in¬ 
formation should be collected on each absence and be considered as a 
minimum for the following items : 

(a) Sex. 

(h) Date absence began. 

(e) Date absence terminated. 

(d) How absence was terminated (returned to work, died, resigned, 
separated, permanent disability, other). 

(e) Reason for absence (sickness, nonindustrial injury, occupational 
disease, industrial injury, other). 

(/) Diagnosis. 

(ff) R>y whom diagnosis was made. 

Tn addition to these items, it is essential to know the number of 
workmen in the plant by sex, in order that rates may be calculated. 

Form 1, attached, is designed to carry information on those absences 
which terminated during a specific month. It is eight inches long by 
10.5 inches wide. 

Form 2 is designed to carry information on those absences which 
mav hav(‘ begun at any time and have not as yet terminated. The 
absences are, therefore, those whose records are carried over into the 
month following the current rejmrting month. The size of this form 
is the same as Form 1. 

Tt must be recognized that while theoretically a rate can be made 
specific for de])artment, occupation, age, sex, and for whatever reason, 
the rate will be of cpiestionable value if the number of workmen in the 
plant is small. Thus the number of workers in the group exposed to 
risk” will determine principally the number of subgroups that may 
be profitably analyzed. 

A periodic analysis of the records, as required by the above rule, will 
iserve to call attention to conditions which are in need of correction or 
control. In some instances a study of the conditions in the plant caus¬ 
ing excessive disability absenteeism will be indicated and may even call 
for the collection of additional data. The sick absences res])onding most 
r(*adily to control are the minor maladies in which tem])erament, 
anxi(*ty, lack of sense of responsibility, maladjustment, and physical 
ill health meet and influence each other. The routine supervision of 
such absences should enable the plant physician to suggest appropriate 
nmiedies. Quite often it is possible for the supervisor of the plant to 
be of considerable assistance in the control of sick absenteeism. Tie is 
in a position to note not only unhealthful and unsafe working condi- 


99 


tions but also early signs of disabling sickness in the worker. Very 
frequently a high sickness rate in a department or plant may be entirely 
due to a few workmen, because of some of the factors indicated above, 
such as temperament, maladjustment or organic disease, in need of 
correction. | 

2. Employer Hesponsihility 

Acceptance of responsibility for industrial health by both manage¬ 
ment and employees is an important factor in a successful industrial 
hygiene program. This factor has long l)een effectively utilized in some 
countries in accident prevention and is now equally successful in the 
prevention of occupational and other diseases in industry. 

The interests of management and labor in industrial hygiene arise 
from at least three sources. In the first place, there is the obligation to 
provide the employee with a safe and hygienic place in which to work. 
Second, there is the dollars-and-cents consideration. And third, far 
beyond any minimum law requirement, there is the benefit which comes 
from saving human life for its own sake and from lessening family suf¬ 
fering’ In short, a good industrial hygiene and safety program achieves 
practical results by: (1) decreasing illness, injuries, labor turnover and 
spoilage of materials; (2) decreasing cost to the workers and employers 
through reduction of wage losses, cost of illness, compensation costs, 
and insurance premiums; (3) improving health and efficiency of all 
personnel; and (4) promoting morale. 

Under our present system of government, employers of labor have 
certain responsibilities under the laws of the Nation. These responsi¬ 
bilities are set forth in the rules which follow: 

Rule.— (a) Every employer shall comply with the various laws and 
codes pertaining to the control of industrial health hazards, and shall 
maintain a safe and healthful place of enij)loyment. 

Purpose of Rule.— Management will, of course, meet laws and codes 
pertaining to the control of health hazards in industry, but it must be. 
borne in mind that such laws and codes present only minimum require¬ 
ments, and therefore represent only a starting point in a well-designed 
program of industrial hygiene. It is therefore the duty of management 
to keep informed of the various laws and codes promulgated in the 
interests of industrial health maintenance, and in the various changes 
in them Avhich may be made from time to time. In this way manage¬ 
ment will be in a position to implement the best known technique in 
industrial hygiene so that they may achieve a healthful working en¬ 
vironment. 

Rule.— (h) Every employer shall determine the health hazards in 
his place of employment hy means of a survey of his establishment. 

Purpose op Rule.— It is axiomatic that before a problem can be 
solved, it has to be defined. Employers will be in a position to solve 
their health problems intelligently once they know what they are. 


100 



! 

I RACTicEs FOR COMPLIANCE WITH IiTLE.—111 the absence of occupa¬ 
tional disease, sickness and accident statistics, healtli liaznrds may be 
, ascertained liy a survey of the workin" environment. Such surveys are 
. conducted by trained engineers and jibysicians, whose services are 
|a^ailable from official agencies, insurance companies, and jirivate con- 
j sultants. ]\Iodern industrial byjjiene practice now has the precise tools 
M hereby specific diseases of occupation and other hazards may be ascer¬ 
tained accurately, and, wliat is more important, information is now 
I available for the control or prevention of practically all known indus¬ 
trial hazards. By takin" advantage of such a survey the employer Avill 
learn the extent of his accident problem, of his rerpiirements as to first 
aid, medical and nursing services, exposure of his workers to various 
toxic materials and other harmful working conditions. lie will also 
^ learn of the best methods for the control of such ex|)osur(‘s. The em- 
I ployer will find that it will pay him to have such a survey made of his 
I establishment, not only because he will be comjdying with the rules and 
I regulations pertaining to this ])roblem, but also in the savings which 
I will accrue to him through the reduction of accidents and disease. 

Rule.— (c) Every employer shall instrucf his emploifces reyardhuj 
the hazards to which they are exposed and the methods which have been 
taken for the prevention and control of such hazards. In all work 
places where special hazards to health exist, employers shall post a 
notice of such hazards in a prominent position in the work place, noti¬ 
fying the workers of the hazard and the means for safeguarding 
against it. 

Purpose of Rule.— Expei*ience has shown that the best results in the 
jirevention of industrial diseases may hi' obtained by enlisting the 
cooperation of the worker himself. One method of achieving this objec¬ 
tive is by instructing employees regarding the hazards incidental to 
their work. Whenever employees have objected or have refused to 
comply with certain regulations, it has been largely due to the fact that 
they have not been informed of the necessity for such regulations and 
the benefit which they themselves will derive from eom]iliance with such 
,rules. Workers consider themselves as thinking people and management 
will find it to be of real benefit to take workers into their confidence, 
inform them of the hazards of employment, post warnings of the 
hazards involved and the desirability of the workers’ cooperation in 
combatting such hazards. By such intelligent use of worker resources, 
employers will not only do a better production job. with a reduction in 
costs, but at the same time will take a real steji forward in establishing 
the worker as an individual, thereby doing away with one of the main 
difficulties in the field of labor relations. 

Praptices for (’ompliance with Rule.— In the instruction of work¬ 
ers regarding the hazards to which they are exposed, supervising jier- 
sonnel, such as foremen, have been found to be the key peojile to pre- 


101 




sent such instruction. This, a foreman can do on an individual basis. 
Naturally the foreman himself must first be informed of the hazards 
and sold on the need for control of such hazards. In some instances, it 
may be found helpful to give the worker a brief and readable pamphlet 
on the safe practices with regard to a specific hazardous exposure. 
Posters have also been found very useful, showing the best practice in 
the prevention of a specific hazard. 

A few of the materials and conditions which require definite instruc¬ 
tion of employees regarding the hazards which those materials and con¬ 
ditions present, and the need for posting notices concerning them, 
follow: 

The handling of most chemicals of a toxic or irritating nature, such 
as certain acids, alkalies, and solvents; heavy metals, such as com¬ 
pounds of lead, manganese, and cadmium; phosphorous compounds; 
and radioactive materials. 

Rule.— (d) Every employer shall install or provide adequate pro¬ 
tective equipment for the prevention and control of occupational dis¬ 
eases and shall maintain such equipment at its highest efficiency and in 
a sanitary condition. 

Purpose of Rule.— The desirability for the employer to provide a 
healthful working place through various methods, such as protective 
equipment and devices, is obvious. Information on the best practices 

of this type are at the disposal of the employer through the. 

. Of equal importance to the provision of protective equip¬ 
ment and devices is the maintenance of such equipment at its highest 
efficiency and in a sanitary condition. Management has learned the 
value of improving and maintaining its machinery of production. 
Similarly, management will find that it is also essential to maintain 
the machinery installed for the protection of the worker. Failure to 
maintain such equipment at its highest efficiency will only serve to give 
the worker a false sense of security and will contribute materially to 
his loss of confidence in both the device and in management. 

3. Employee Responsihility: 

Rule.— (a) Every employee shall use the protective equipment pro¬ 
vided hy the employer for the prevention and control of occupational 
diseases. 

Purpose of Rule.— Employees should understand that the principal 
function of the protective equipment provided by the employer is to 
protect his health, which is his greatest asset, and that therefore he 
should use such equipment and instruction from the employer in accord¬ 
ance with regulations. Failure to do so may not only result in an injury 
to the employee and his fellow workers but may also jeopardize the 
worker’s rights under the compensation law in case of injury. 

Rule. —(&) Employees shall not abuse or mishandle in any mamier 


102 





I 

I 


I 

I 


equipment provided hy the employer for the workers^ protection against 
health hazards. 

Purpose op Pule. —In ortler for the protective equipment to func¬ 
tion properly, it sliould not be abused by anyone. The employer has 
both the ri"ht and the obligation to compel the use of equipment for the 
prevention of industrial diseases. 

Practices for Compliance with Rule.— Workers should never re¬ 
fuse to utilize the ])rotective devices given them, nor abuse such devices. 
Goggles furnished workers to protect them against radiant energy, or 
against dusts or other foreign objects which may enter the eye, should 
be worn at all times. The same is true for respiratory protective equip¬ 
ment designed to protect the worker from toxic atmospheric contami¬ 
nants. Local exhaust ventilating systems and wet methods for allaying 
dust, such as wet drilling, should be used by the worker in accordance 
with instructions and any failure of such equipment which the worker 
may note should be reported to his supervisor immediately. Protective 
clothing, such as headguards, safety shoes, gloves, aprons, and other 
equipment of this character, should be worn in accordance with instruc¬ 
tions and maintained in satisfactory condition. The employee should 
remember at all times that occupational diseases are no respectors of 
persons and sooner or later will exact their toll, if the worker fails to 
use the protective measures which have been jHOvided him. 

Rule. — (c) Ei^vny employee shall comply with all healthful prac¬ 
tices agreed upon between the employer and employee organization. 

Purpose of Rule. —The employee should realize that the healthful 
practices recommended by management and by his own organization 
are designed to prevent injury to himself and to his fellow workers. 
The employee is often in a position to note unhealthful practices among 
his fellow workers and is therefore in a position to utilize his influence 
on his fellow workers to secure compliance with the regulations. 


4. Lnhor-Mdunyiement Comniittees 

Rule. —In all establishments that have 50 or more employees there 
shall be allowed the formation of a joint committee of equal representa- 
* tion from employer and employee groups for the exclusive purpose of 
health maintenance. 

Purpose of Rule. —The increasing interest of labor unions in the 
health of their members has indicated conclusively the need of a joint 
approach on the part of management and labor to a solution of indus¬ 
trial health problems. 

Practices for Co.mpliance with Rule.— It is conceded that there 
are difficulties in the way of effective labor-management cooperation in 
industrial liygiene which must be recognized at the outset in attempting 
to bring these two groups together. Since management and labor both 
have so much to gain by cooperative and intelligent application of 


103 





industrial hygiene metliods, it is tragic that so much misunderstanding 
and resistance on both sides still exists in many indnsti'ies. ^lanagc- 
ment often introduces healtli ruh's witliout consulting tlie workei'S. ddie 
workers have at times used their union strength to o])i)ose measures 
which would henefit them. There are still many firms and unions whose 
activities show no evidence of consideration of tlie health needs of the 
workers and the necessity for a healthful working environment. De- 
S]hte new signs of increased interest in workers’ health on the ])art of 
unions, some segments of labor are apparently still more concerned for 
compensation benefits than for prevention of conditions which caused 
the compensable injuries—injuries which can never be compensated by 
cash benefits. On the other hand, attitudes of management towards in¬ 
dustrial health run the entire gamut from paternalism to neglect. In 
general, most large industrial establishments have adopted an enlight¬ 
ened ai)proach to industrial health measures, which ensure to their 
workers high quality service and constant attention to the working 
environment. 

What is therefore needed on the part of both labor and management 
is a new attitude towards the problems of industrial healtii. Idie expe¬ 
rience in some industrial countries has shown that formula can be 
devised which will harness the power of lal)or organizations with the 
splendid organization which management has created in nmny plants, 
so that the two will not oppose each other, but pull together as a team 
towards the common goal. This was not only true in the held of pi'o- 
duction, but also in regard’to industrial hygiene which is so intimately 
related to production. We have on record many instances of the effec¬ 
tiveness of labor-management interest in the field of industrial health. 
These committees, through their joint effort, have been the means of 
instituting im])rovements in the medical service and in bringii>g posi¬ 
tive health to the workers through such modern methods as tuberculosis 
and venereal disease case finding ])rograms, nutrition programs, and 
welfare programs. There is sufficient evidence to show that health and 
working conditions are sul)jects of vital importance to fhe Avorker. 
Labor and management Avill find that a joint committee to advise both 
groups on the health needs of the workers and on ways and means to 
meet these needs will ])ay dividends. Information on the organization 
of such a committee can be obtained from the. 

5. Notsfication of the Creation of New Estahlishinents, Proeesses, 
or Changes of Processes 

ItuLES —Every employer shall notify the . 

within W days of the estahlishment of a new enterprise, proeess.or 
change in process, and whenever practicable, shall furnish the 

. u’ith plans and specifications of such new 

or changed processes. 


104 






J nupost: OF Rule.— i\Iany serious oeciipatioiial diseases liave oc- 
eiiied in industry heeaiise ot' a laek of knowledge on the i)art of l)otli 
nianajreinent and the workers re<j:ardin<j: hazards involved thron«j:h the 
intiodiietion ot new machinery, new clieinicals or new processes. It is 
obvious, tlierefore, that it would he of distinct benefit to manat^ement 
to keep the . fully informed of all the inti¬ 

mate details of operations, especially with regard to the use of new 

materials and processes, since the . has in- 

! formation concerning the control of industrial hazards. 

A firm building a new ])lant will find it of distinct advantage to in¬ 
clude at the blueprint .stage, health protection features of such a new 
enterprise. The review of plans and s])ecification.s for new operations 

or changes in operation by the trained technical staff of the. 

I . will -save management and labor both in co.sts and 

I difficulties. 

I 

H. KiiviroiiiiieiUal lioiiditioiis 

I. General 

Rule.— There shall not exist in any plaee of employment any proeess, 
material or condition known to have an adverse effect on health unless 
provisions are present to maintain the occupational environment in 
such a state as to prevent the existence of a health hazard. 

Practices for Compliance with Rule.— One of the major causes 
of lost time in industry is workers’ ill health, some of it caused by 
physical conditions in the job environment. Although industrial 
hygienists now have the techniques to prevent almost any kind of 
occupational disease, unfortunately, the aiiplication of this knowledge 
has not jirogressed as rapidly as it has been acquired. The task, then, is 
the promotion of industrial hygiene techniques, .so that they reach every 
industiy in the nation. 

Compliance with the general rule enunciated above will enable in- 
du.stry to maintain the health of its workers at a high level. It is also 
^ felt that the rule is sufficiently reasonable so as to be reconciled with 
the chief aim of industry, which is to turn out goods and services in 
the most efficient way possible, in order to achieve maximum produc¬ 
tion at a minimum cost. 

One way for industry to comply with the above rule is to survey its 
problems and then take the neces.sary steps for their control. 

To ensure com])liance with the rule mentioned above, management 
will find that it requires three types of .services: (1) iMedical, (2) En¬ 
gineering, (2) Welfare. 

The medical service should consist of a well-qualified physician or 
physicians, the nece.ssary nursing service, and other technical assistance 
from ancillary profe.ssions, such as dentistry, medical technician.s, and 


105 








so on. In order to carry out the medical program there will be required 
on adequate and Avell-equipped dis])ensary. 

The engineering service may lx* obtained from the . 

. and will serve to present and control environmental con¬ 
ditions in the plant which endanger health. Some industries may find 
it useful to have health committees to advise and assist in the investiga¬ 
tion of diseases and to help to formulate health rules and regulations 
for the industry, and to see that such recommendations are followed. 
Some industries will also find it desirable to have at least one trained 
first aid worker. 

In every modern industry there are one or more conditions peculiar 
to the particular process and operation, which are potential threats 
to the health of the workers. Most of these can he eliminated or reduced 
to harmless limits by engineering methods. Further protection of the 
worker must sometimes he provided by supplying approved devices and 
clothing. The most important occupational hazards are: 

(1) Exposure to poisonous fumes, dusts and gases, which maj" result 
in serious, acute or chronic illness; 

(2) Excessive noise and vibration ; 

(3) Poor illumination, such as insufficient lighting, or glare; 

(4) Excessive heat, cold, or humidity; 

(5) Contact with chemicals and other substances which produce 
siekness and diseases; 

(6) Operations which may result in accidental injuries, burns, euts, 
crushing, and so forth; 

(7) Overcrowding in the work room ; 

(8) Poor ventilation in the work room; 

(9) Poor housekeeping. 

By means of an industrial hygiene engineering survey of all these 
hazards, they may be appraised by scientific means and the necessary 
recommendations for controlling them may be obtained. It is wise, 
once the recommendations have been complied with, to request a re¬ 
survey in order to learn whether the recommended changes have accom¬ 
plished the purpose for which they were made. 

There are many other problems in industrial hygiene in addition to 
those specifically caused by unhealthful conditions. Many of these may 
be solved or controlled by the application of certain welfare provisions. 
Industries have found it of distinct advantage to see to it that their 
workers have proper housing, sewage disposal, safe water supply, safe 
milk supply, safe and nutritious food, and at times to have programs 
to advise workers on their personal problems, and a general health 
education program. 

With regard to the environmental control of working conditions, it 
is desired to emphasize once more the importance of investigating, in 
advance of installation, all the processes, materials, or modifications, in 


106 




order to prevent the introduction of nnexj^ected exposures; and finally, 
too much slr(‘ss cannot he ^iven to the importance of maintaininj? con¬ 
trol measur(‘s throu»;h periodic i)lant inspections and maintenance. 

2. Maximum Allowable Concentration for Atmospheric 
(U)ntaminants 

UuLE. —There shall not be used any process or material which will 
liberate any contaminant into the atmosphere of occupied areas, unless 
arrangements are present to prevent the contaminant from injuring 
any part of the body or reducing in efficiency the normal function of 
any part of the body. The )}iaximum allowable concentration for attnos- 
pheric contaminants in occupied areas shall include, but is not re¬ 
stricted to, the following substances and their corresponding maximum 
allowable concentration indues. 


t 


(;AS!:S AM) VAPOKS' 


(Ports pvr orittiou) 


Hiihstance 

Acetone - 

Acrolein- 

Ammonia- 

Amyl acetat(>- 

Aniline - 

Arsine- 

Benzene - 

Carbon disnUiile- 

Carbon monoxide __ 
Carbon tetracldoride 

Chlorine- 

Ethyl ether- 

P’ormaldehyde- 

Ga.soline- 

Hvdrofjen chloride 

• * 

Hydroj^cn cyanide 
Hydrogen Ibioride 
Hydrogen snlti<le __ 

Methanol- 

Naphtha (coal tar) 
Nitrogen oxides __ 

Nitroglycerine - 

1‘ho.sgene- 

Stibine- 

Sulfur dioxide- 

Trichlorethylene- 

Toluene - 

blbOlb—10—b 


Concenirotion 

500 

0.5 

100 

200 

5 

0.05 

55 

20 

100 

50 

1 

400 

5 

500 

5 

10 

O 

20 

200 

200 

25 

0.5 

1 

0.1 

10 

100 

200 

107 





























TOXIC DUSTS, FUMES AND MISTS 

(MilJif/rdiH.s per enhie meter) 

lUiJm.tance 

Antiiiioiiv (metal and oxide')_ 

Ai-senic ( nu'tal and oxide)_ 

Cadmium _ 

riu’omie acid_ 

Lead _ 

xMercuiy_ 

Zinc oxide _ 


Concent ration 

0.5 

0.5 


0.1 

0.1 

0.15 


MINERAL DUSTS J 

(Million particles per enhie foot) ' 

Huhslance Concentration ■ 

Asl)Cstos_ 5 

Silica (more than 70%)_ 5 

Silica. (40%, to 70%)_ 10 

Silica ( to 40%,)_ 20 

All dusts (less than 5%, silica)_ 50 


X-i'avs 


RADIATION 


0.1 roentgen unit per S hour exposure 


Purpose oe Rule. —I>y limiting: the exposure of workers to the con¬ 
centration values listed in the rule, reasonable assurances will be ob¬ 
tained that the workers will not be injured or their efficiency and well¬ 
being impaired. 

Practice for Coaipliance with Rule. —There is at present available 
a sufficient body of knowledge regarding the toxicity of many materials’ 
employed in industry, so that they may be limited in the atmosphere 
of occupied places to safe concentrations. Some of the limits for atmos- 
l)lieric contaminants are based on clinical and physical information,; 
while others find their baAis in what can be accomplished through 
good engineering ])ractice. Industrial hygienists feel that it is their 
duty not only to prevent injury to the worker’s health but also to make 
him reasonably comfortable and efficient in his working environment., 
In other words, not only must we i)revent a worker from being 
poisoned, but we must also prevent physiological responses which cause 
discomfort and unjileasantness, but not necessarily injury to health. 
Enlightened management has found that it is good ojierating practice, 
to control the working environment, so that even mild physiological 
responses that are causing discomfort are kept at a minimum. In fact,' 
it is a good })ractice to keep them at a minimum because quite fre-; 
(piently such uncomfortable conditions make a worker accident-prone,! 
as, for example, when a worker becomes inebriated from inhaling cer-| 
tain kinds of solvent vapors. No one in industry has questioned, for 


108 
















example, tlie standards adopted in Ihe Tinted States for eliromic aeid 
mists result inj; from ehromiiim eleeti-o-platin<r op(*rations. These mists 
do not eans(‘ sysPonie injury, hut do produce, umhu- certain conditions, 
irritation ot tlu* mucous meiuhraiu's and destruction of part of tlie 
nasal sejituui. Throu^li (‘ducational efforts in tlu* electrojilatinjjr indus¬ 
try itself, it has hecn a relatively simiile matter to obtain "ood operatiiij^ 
techniipies, so that chromic acid levels are kept well below the jioint 
where these minor injuries and discomforts can occur. 

The limits set forth in the above rule are capable ot' attainment 
through good engineering practice. They have been found, on the 
other hand, to cause no serious handicat) to industry in the matter 
of compliance. Administrative agencies, however, should realize in the 
enforcement of this rule that the determination of whether a working 
condition is safe or unsafe, depends on other factors besides that of 
maximum allowable concentration in the atmos]diere. IJefore an indus¬ 
try is told that it should make certain ])rovisions to control conditions 
suspected of being inimical to health, a complete survey is in order. 
Such a survey should involve at least two criteria in determining 
the safety of an operation. First, it is essential that the health of those 
workers ex])osed to a cert iin material or condition should he carefully 
investigated. This may involve not only an examination of the worker’s 
health record, but also an examination of the worker himself. Second, 
careful environmental studies should he made which would include not 
only certain determinations of the atmosphere, hut also a thorough 
sanitary survey and occuiiational analysis. The sampling and deter¬ 
mination of atmos])heric contaminants should he made by approved 
and standard procedures. All these, juit together, should yield data of 
real value in helping to control industrial health hazards. 

Certain sections of this discussion present details for maintaining 
safe atmospheric concentrations. 

3. Skin (Umtnrt wii/i Hazardous Material 

Rule.— Where ihe sKbstauees eneountered are eapahle of eausDui 
any patholoyieal chauye in ihe skin, adequaie preeauiions shall he 
taken to prevent these suhsianees from eontaeiniy the skin. 

Where ihe suhsianees eneountered are eapahle of heiny ahsorhed 
through ihe skin or mueous memhrane iherehy produeing injury io 
health, adequate preeauiions shall he taken to prevent these suhsianees 
from contaeting the skin and/or ihe mueous memhrane. 

Purpose of Rule. —Most chemicals either in the juire form or in 
solution can cause dermatitis when in contact with the skin over a 
prolonged period ot* time; cons(*(pU‘ntly, most chemicals may he haz¬ 
ardous for repeated daily industrial contact. Although dermatoses are 
usually not serious, they may he prolonged and cause considerable 
economic loss both to workers and em]doyers. Furthermore, a few 
chemicals may he absorbed through the skin and cause systemic iioison- 

109 


ing. Most notable among these are tetraethyl lead, mercury, and 
hydrogen cyanide. The ])urpose of the rule is therefore to prevent 
injury hy repeated contact with such agents. 

Practices for Compliance with Pule. —Continuous or repeated , 
contact with dermatitis-producing agents such as organic chemical | 
solvents, solutions of or solid caustic, and organic chemical dusts may 
be prevented by isolation of the worker from the material, by exhaust 
ventilation, by the use of protective clothing, and by supplementary 
washing facilities. 

By isolation is meant complete removal of contact of the skin with 
chemical agents. Thus, liquid chemicals should be handled in pipes 
and closed vessels rather than in buckets or other open vessels. This 
procedure not only eliminates contact, but also reduces the likelihood 
of spillage of material on the clothing which may cause continuous 
contact. Another manner of isolation is the use of mechanical equip¬ 
ment for dipping parts into solutions. This may be a mass production 
arrangement of the use of tongs or other manual handling devices.-j 
These arrangements are particularly useful for dip painting, for pick¬ 
ling and metal cleaning in general, and for impregnating operation-^'. 

Exhaust ventilation should be used to remove from the working i 
environment irritating chemical dusts which may settle on the skin 
of the worker thereby causing dematitis or other injury. Processes i: 
involving the use of alkali powders or organic dusts which may escape 
into the atmosphere should be ventilated. (See section on ventilation. ) ! 

Protective clothing should be used when other means fail to prevent 
the contact of the skin with harmful chemicals. The purpose of such 
equipment is to prevent such material from touching the skin when 
splashed, settled, or reached into. 

Protective clothing for this purpose includes gloves, gauntlet gloves, 
full arm covering, face shields, full head covering, aprons, jackets, 
pantaloons, and footwear. The clothing must be impervious to the 
material in question, otherwise, it may soak in and be in continuous 
contact with the skin. Impervious clothing includes that made of 
rubber, synthetic rubber, synthetic plastics, or cloth impregnated 
with these materials. It may also include items made of asbestos for 
protection against physical burns. The use of protective skin ointments 
is not recommended except for very brief exposures to relatively mild 
chemicals. In connection with the use of such protective equipment, 
guidance should be sought from the plant physician. 

Supplementing the previously mentioned means, adequate Avashing 
facilities should be available for workers exposed to dermatitis hazards. 
After every work shift and at least once during the shift, such Avorkers 
should wash extraneous chemicals from the skin. This implies that the 
employer should furnish hot and cold running Avater, an adequate 
basin, Avashing soap, and drying facilities. In cases Avhere the poten- 


110 




tiall} irritating material may contact the body as a whole, shower 
baths should be furnished. It is clearly the responsibility of the worker 
to use these facilities. 

In some instances when it is impossible to avoid irritating chemicals 
getting on the clothing, clean clothing should be furnished to the 
workers at regular intervals to prevent repeated contact of the skin 
\sith contaminated clothing. Such clothing may be furnished at in¬ 
tervals of from one day to one week depending on the severity of the 
hazard. 

In all of the above mentioned recommendations, good housekeeping 
and cleaning up of the spilled chemicals is implied. (See section on 
I housekeeping.) 

» The handling of tetraethyl lead must be done with the utmost care 
to prevent skin contact. Tetraethyl lead or its mixture with other 
I organic liquids should be contained in closed vessels and pipes and 
all contact with the chemical must be avoided by tlie means mentioned 
above. Exposure to hydrogen cyanide should not be over 1 percent 
by volume in the air even for the worker protected from breathing 
such a concentration, since the gas is absorbed througli the skin in 
such concentrations. 

4. Infectious Agents 

Rule.— There shall not exist in any occupied area any processed or 
unprocessed material containing infectious agents unless provisions are 
present to prevent the infectious agents from injuring any part of the 
body or reducing in efficiency the normal function of any part of the 
body. 

Purpose of Rule.— In certain types of industry such as animal 
husbandry, tanning, hide-handling, and cattle slaughtering it is pos¬ 
sible that infections, present in the animals, may be transmitted to 
workers. The purpose of the rule is to prevent the occurrence of such 
infections in workers handling potentially infected animal products. 

Practice for Compliance with Rule. —Of primary importance is 
the prevention of diseases in the animals. To this end, herds should 
be inspected for anthrax and glanders, and infected animals should be 
disposed of in such a way that the infection cannot be transmitted. 

In the handling of animal carcasses and hides, i)rotective clothing 
should be used for two purposes. In the first place, direct contact of 
workers with hides and carcasses should be prevented as far as pos¬ 
sible. In the second place, protective clothing should be used to pre¬ 
vent the occurrence of cuts and abrasions among workers handling 
the materials. Every precaution should be taken to thoroughly disin¬ 
fect cuts and abrasions when they do occur, since the infecting or- 
^nism usually enters the human body through the broken skin. Pro¬ 
tective clothing should be kept clean and in a sanitary condition. Some 

„ SI 81)48—ID—9 




industries may find it necessary to thoroughly disinfect hides, wool 
or carcasses before processing them. 

In addition good personal hygiene must be practiced by the workers. 
This implies that the employers in establishments where such infectious 
diseases may occur should provide adequate lockers, change rooms, 
soap and towels, and washing facilities with running water. All cloth¬ 
ing which comes in contact with i:)otentially infected material should 
be laundered and disinfected. It is preferable that the employer 
furnish clean clothing to workers at regular intervals. 

5. Illumination 

Rule.— The quality and quantity of illumination in any occupied 
area shall he adequate to permit the performance of all necessary work 
in a safe manner and without injury to the eyes. 

Purpose of Rule.— Illumination is a necessary factor in the environ¬ 
ment where any type of work is done, and it must be available when¬ 
ever work is in progress. Since most tasks require visual effort to a 
greater or less degree, the amount of illumination available must be 
sufficient for the eyes to see the work. However, it is possible for 
excessive quantities of light to reach the eyes without improving the 
illumination on the work being done. Such excessive illumination may 
injure the eyes over a period of time. 

On the other hand, lack of illumination is a i)otential cause of acci¬ 
dents, loss of efficiency, inaccuracy, and reduced production. The pur- 
]:>ose of the rule therefore is to insure that the working environment 
is satisfactorily illuminated in agreement with reasonable standards. 

Pra("'1'ices for CoMPiiTANCE 'WITH RuiiEs.— Lighting may be from 
naturnl sources during daylight hours or from artificial sources. In 
some cases a combination of both is required. The most easily accom¬ 
plished illumination is by the use, during daylight hours, of windows 
and skylights. It should be assured, however, that no working place or 
other occupied area is at too great a distance from the source of illu¬ 
mination to be adequatel}^ lighted. 

Artificial illumination may be provided by electrical lighting or other 
(•(piivalent means. For such artificial illumination, two general ar¬ 
rangements are possible; namely, general illumination and local or 
spot illumination. The latter should be used ]^rimarily as a means 
of su[)plementing general illumination at those work ])oints where 
especially good lighting is needed. General illumination means that 
lighling is available over a more or less large area. Lights for this pur¬ 
pose should be placed at least three meters above the floor and should 
diffuse the light downwards. Lighting fixtures for this purpose should 
be spaced at such intervals that the illumination at an elevation of 
one meter above the floor level is approximately eipial in all parts of 
the working area. This same general standarcj should apply to natural 
illumination provided by windows and skylights. 


112 


Spot illumination implies the stronger lighting of a small area and 
is usually accomplished by means of electrical fixtures. Such illumina¬ 
tion should be used for tasks recpiiring greater visual effort than is 
needed in other parts of the working area. The light should l:e so 
arranged that it produces the necessary effective illumination at the 
point of work. 

In all cases, the quality of the light must be such as not to impair 
the vision. The major lighting difficulty is that of glare which is either 
a reflection or a direct radiation of the light to the eyes from its source*., 
Such glare greatly reduces the visual acuity. It may be overcome. b,\‘^ 
facing the worker away from the source of illumination or by intqr^ 
rupting reflections from smooth surfaces. Such a smooth surface nuiy 
be painted a dull light-absorbing color or may be replaced by a roughi 
surface. Direct glare from light sources should be reduc(*d by means 
of properly shaded light fixtures or by interposing a barrier in front 
of the light source. 

Another quality of illumination is the color, not only of tin* source 
but of the surrounding reflecting surfaces. In general, the darkei* 
colors are more comfortable for the eyes, but the lighter colors reflect 
and make useful more of the light. Walls and ceilings should be 
painted with light colors, whereas work benches, floors and other sur¬ 
faces on which the work is done should be painted with darker colors. 

It is possible also to simplify visual tasks by means of contrasting 
colors. This implies that the background is of a different color than 
the parts being worked on, or that the different parts of moving ma¬ 
chinery arc painted with contrasting colors so that they are readily dis¬ 
tinguished one from another. In such cases the moving jnirts whieli 
create the danger should be painted a light color against a dark back¬ 
ground. 

The maintenance of the source of illumination should be carefnlly 
attended to. This implies that windows, lights, and light fixtures 
should be washed at frequent intervals in order to maintain their 
efficiency. Walls, ceilings, and other light-reflecting surfaces similarly 
should be kept clean. Burned out light bulbs should be immediately 
replaced. 

Illumination may be measured by means of instruments which in¬ 
dicate the number of foot-candles of incident light at a given point. 
Therefore, it is suggested that specific quantities of illumination .should 
be available for various types of work depending on the visual rc*- 
quirements of the work. Attention to fine details, for example, recpiires 
a relatively high level of illumination, whereas the simple act of walk¬ 
ing on cleared floors or stairways re(piires a low level of illumination. 
The following table should be considered as a guide to the minimum 
(juantity of inumination which should be available for difi'erent general 
types of visual tasks: 


Visual task 

1 . Walkaways—and near moving machinery- 

2. Stockroom and low seeing requirements- 

3. Coarse work (such as casting, machine tending)- 

4. Coarse work at hazardous machinery (and moderate seeing tasks) — 

5. Fine machine and bench work, fine inspection (and other exacting 

seeing tasks) - 


Foot-candle 

0-5 

5-10 

10-20 

20-30 

30-50 


6. Temperature^ Humidity and Air Movement |j 

ItULE .—Natural or mechanical ventilation shall be provided in allf,\ 
occupied areas to insure a healthful and, so far as feasible, a coni-^\ 
fortable environment with regard to temperature, humidity, heat j j 
radiation and air movement. i 

Purpose of Rule.— This rule implies that attention should be given i 
to the temperature and humidity of the air in workrooms even when 
no possibility exists of the persons in the room being exposed to harm¬ 
ful contaminants. It has been found that the physical conditions of ^ 
the air aftect the efficiency of the workers, and in extreme conditions ; 
their, health as well. The most comfortable conditions for specific types ■ 
of work are usually those under which the work is best performed. 1 
Arduous labor, for example, may be accomplished at relatively Ioav ? 
temperatures, whereas sedentary work is best done at a temperature of > 
about 21° centigrade. 

The humidity and motion of the air also has its effect upon com¬ 
fort and upon health. Certain combinations of air temperature and 
humidity make work impossible and injurious, although the addition ■ 
of a strong localized air movement may alleviate the conditions. ; 

The purpose of this rule is to suggest conditions and limitations con- > 
cerning temperature, humidity and air movement as related to the . 
environment of work places. i 

Practices for Compliance with Rule. —Aside from the special I 
ventilation required in some working locations to remove atmospheric ; 
contaminants from the environment, general ventilation should be | 
available to provide some fresh air in all occupied areas. This may be ‘ 
accomplished by means of natural ventilation, which implies that a ,i 
sufficient number of openings are available in the building or other I 
structure, or by mechanical means. The latter implies that power- 
driven fans are used to force air into or to remove air from the oc¬ 
cupied enclosures or structure. 

On the average, approximately one-half cubic meter of air per ' 
person per minute should be changed within an occupied area in order | 
to maintain comfortable conditions. If natural ventilation is utilized j 
to accomplish this air change, the relative area of windows and other I 
0 })enings used for ventilation should be about 10 percent of the fioor 
area served by the ventilation. Since ventilation is related to the 
occupancy of the building, it is suggested that the space volume per 
person in the workroom or place should be at least 10 cubic meters. 


114 









^\ hen outdoor conditions are very cold, it is preferable that the 
entering air be heated almost to the room temperature and that it entei* 
the space without creating a draft in areas occupied by workers. This 
may be accomplished by placing baffles inside the windows or by 
placing the air inlets at a height of at least 3 meters above the floor 
level and directing the air current u})wards. 

The entrance of fresh air into a building or space implies that an 
equivalent amount of air leaves the building or space. Thus air outlets 
as well as inlets must be furnished if general ventilation is to be 
operable. 

The temperature of occupied areas may be raised by the use of 
heating devices such as unit electric heaters, central heating systems, 
gas, oil, wood or coal burning unit heaters, or other means. Care 
should be taken that unit furnaces have good stacks and draft, so that 
carbon monoxide and other gases do not escape into the working area. 
(See section on maximum allowable concentrations.) 

Humidity is closely related to temperature as it affects the air 
conditions of an environment. Relative humidity means tlie actual 
amount of water vapor in the air as related to the maximum amount 
of vapor which could be present at a given temperature. With high 
atmospheric humidities, it is impossible to cool the human hod}" hy 
evaporation. This implies that certain combinations of air temperature 
and humidity may be injurious to health. Quantitatively, the wet bulb 
temperature should not be above 32° centigrade, if the dry bulb tem¬ 
perature is as high as 49° Fahrenlieit. For the most part, a relative 
humidity between 30 and 70 percent is the most comfortable for tem¬ 
perature ranging from 5 to 27° centigrade. 

Processes within the working place may add either to the tempera¬ 
ture or to the humidity of the area. It is not intended that tliese sug¬ 
gestions should limit this effect except to the extent that unhealthy 
conditions should not exist. Where furnaces or other high temperature 
equipment are in use, ceilings should be high and extra amounts of 
fresh air should be brouglit into the working environment by ventila¬ 
tion. When excessive humidity is created by processes or conditions 
which are not necessary to tlie process, extra ventilation should also 
be provided above the suggested amounts, in order to maintain reason¬ 
ably comfortable conditions. 

In specific hot locations such as work areas in front of high tem¬ 
perature furnaces, a blast of air may be directed on the workers in 
order to make their work more comfortable provided that the humidity 
of the air is not excessive. Such an air blast should be of a])proximately 
the same temperature as that of the air in the working area in order 
not to create unhealthy conditions. Other means arc also available to 
cool individual workers in i)articularly hot environments, such as the in¬ 
side of partially cooled boilers or kilns. These consist of asbestos suits 


115 


within which a blast of fresh air is introduced by hoses from a cooler 
environment. 

For protection of workers against heat radiation from high tempera¬ 
ture sources such as furnaces, reflecting metal shields may be imposed 
between the worker and the source of heat without interfering with 
the work to be done. Asbestos clothing such as gloves, arm coverings, 
aprons, and face shields may be provided to protect the worker in¬ 
dividually. 

It is not intended that these practices should imply the need for 
air conditioning in hot climates or in hot environments. HoAvever, 
where hot environments occur industrially in cool or cold climates, 
change houses or rooms should be provided, so that workers may change 
clothing and bathe with warm water before being exposed to the 
cold conditions after the work shift. 

7 . Noise 

Rule.— There shall not exist in any occupied area a}ny process or 
operation producing noise unless provisions are present to prevent the 
noise from injuring any part of the body or reducing in efficiency the 
normal function of any part of the body. 

Purpose of the Rule.— Noise may be defined as an excess of sound 
of any pitch. Such sound excesses are known from experience to pro¬ 
duce over a long period of time, not only fatigue and inefficiency in 
exposed persons, but, in extreme cases, impaired hearing. The hearing 
may be impaired for a small range of the wave lengths which constitute 
sound or for nearly all of the audible wave lengths, in Avhich case a 
condition approaching total deafness occurs. The purpose of the rule 
is to reduce the possibility of such injury. 

Practices for Compliance with Rule.— Industrial noise is usually 
the result of machinery operation, of the escape of the use of com¬ 
pressed air in pneumatic tools, or of fabricating heavy metal parts. 
Friction and vibration frequently play a major part in the production 
of noise. The first approach to noise reduction, therefore, is the reduc¬ 
tion by maintenance of friction and vibration in moving parts of ma¬ 
chinery. This elimination of noise at its source includes the replacing 
of worn parts and oiling of moving parts such as gears and bearings. 
Other means of eliminated source noises include the mounting of ma¬ 
chinery on rubber or on solid foundations, the use of direct or belt 
drives in place of open gears, or the enclosing of such gears in non¬ 
vibrating housings. 

Other means of noise reduction are the isolation of noise producing 
operations, the use of sound insulation, and the use of personal pro¬ 
tective devices. Frequently, the noise producing equipment may be 
removed from a main workroom to another location where a relatively 
small number of persons will be exposed. If such a location is sound 


116 


insulated, very little sound will escape to the main workroom and the 
noise exposure of the operators will he reduced to a minimum. 

bound insulation may he used not only in small enclosures such as 
mentioned above hut also in larpre workrooms. Sound insulation is a 
means for reducinjr reverberations within a workroom or other en¬ 
closed space, l^y sound insulation is meant the lining; of the enclosure 
or room Avith sound-ahsorhiu" materials. Such materials may he heavy 
tapestry or cloth hang:in" one or two inches away from a Avail, or soft 
jierforated material, such as composition hoard, lightly hut firmly at¬ 
tached to the Avails and ceilin". Such sound insulation Avill appre¬ 
ciably reduce sound levels in noisy areas. 

For protection of indiA’iduals umiA’oidahly exposed to excessiA’e noise, 
personal protection should he provided. This ]U’otection may take the 
form of lightly oiled cotton i)lu"s which may he placed in the outer 
ear canal, or of commercial ear defenders, Avhich will serve the same 
I)urpose of reducin" the intensity of noise vibration reaching the ear¬ 
drum. As in the case of other personal protective ecpiipment, the more 
permanent means of noise elimination should he used as much as ])()s- 
sihle. These more permanent methods include elimination of noise at 
its source, isolation of noisy operations, and the use of soiuid insulation. 

V ihratioii 

IxUi.E.— WJierevcr anif process or operotion producing vihratioo is 
condnefed in (ini/ occupied urea, provisions sJudl he })rcscnf to prevent 
the vibration from injuring an]f part of the hod]i or reducing in effi- 
eiene\i the normal functions of anjf part of the t)odj/. 

Purpose of Pule. —Pertain industrial oiierations, ])articularly those 
requiring the use of ]nieumatie tools, create ra])id aTid vijzorous vibra¬ 
tion Avhich Avithout adecpiate precautions may he translated directly to 
the person ])erformin^ the Avork. Excessive vibration of this type may 
produce injury to the ])erij)heral nervous system and to the joints of 
the body. The i)ur])ose of the rule is to prevent such injury. 

Practices for Pomiu.iaxce avitti Piu-e. —Vibration as inter[)reted 
in this rule should not he confused Avith noise associated Avith the use 
of pneumatic tools. (See section on noise.) 

The first means of ]U’eventin" excessive vibration is to chaufre the 
j)rocess Avhere ])ossihle. For example. Aveldinp: may he ])raetical in 
place of rivetiu". 

Insofar as jio.ssihle ])neumatie tools should he held in position 
mechanically, ])articularly‘ in the case of the nuMliiim Aveifrht tools 
Avhieh have a hijrh impact. Such mechanical holdin^^ Avill prevent the 
translation of tin* vibration to the worker. Where it is not po.ssihle 
to hold the tools nu'chanically, Avorkers should he provided Avith jiadded 
‘rlov(*s or Avith other resilient paddinjr Avhich prevents direct contact 
of the tool Avith his person. In cases Avhere direct contact of the vihrat- 


117 




ing tool can not be avoided, the length of daily contact with the 
vibrating mechanism should be kept at a minimum. 

9. Pressure 

Rule.— In occupied areas where the workers are subjected to 
abnormal atmospheric pressures, provisions shall be present to prevent 
injury to any part of the body or reduction in efficiency of the normal 
function of any part of the body of the worker upon entering, working 
in, or leaving that area. 

Purpose of Rule.— Both excessive and diminished air pressures may 
have a profound physiological effect on the human body. With 
diminished pressures, such as are encountered at high altitudes, the 
lack of oxygen may produce excessive fatigue and other effects. Exces¬ 
sive air pressure may be encountered where work is done under water 
or under ground when the pressure must be increased to exclude water. 
Subsequent effects of such increased pressure may cause the condition 
known as “bends.” The purpose of the rule is to prevent the oc¬ 
curence of such physiological maladjustment. 

Practices for Compliance with Rule.— Life and work may be ac¬ 
complished at altitudes as high as 5,500 meters, provided that time is 
allowed for adjustment of the individuals to such altitudes. At high 
altitudes the oxygen available for respiration is considerably reduced, 
and the lack of oxygen is partially compensated for by changes in the 
blood physiology. These changes require several months’ time before 
complete adjustment is made. 

For any kind of work in altitudes above 5,500 meters oxygen should 
be furnished from a known safe supply. This implies that a source 
is available at all times and in a portable manner. 

Increased air pressure, greater than that encountered at sea level, 
may be used for tunneling and shaft sinking where water must be 
kept out of the working place. Under no conditions should the pres¬ 
sure be more than 5 atmospheres if the work is to continue for a full 
8 hour shift. Persons should not be subjected to pressures greater 
than 5 atmospheres for more than 1 or 2 hours at a time. 

In no case where work must be done under increased atmospheric 
[iressure should the increase or decrease of pressure be made at a rapid 
rate. The pressure decrease to normal should be made according to 
standard practices in time intervals such as shown below. 

This stepwise decrease of pressure largely eliminates the possibility 
of occurrence of “bends.” In addition there should be available an 
auxiliary compressed air chamber in which affected individuals may 
be recompressed and returned to atmospheric pressure at even slower 
rates. A supply of oxygen should be available in such a recompression 
chamber for additional relief of pressure effects. 


118 


Fable 1.— f^ressnre shifls anil intervals of work for each 2't-hour period 


I’n’s-siire 

Hours 

Column 1 

Column 2 

Column 3 

C’olumn 4 

Column 5 

(’olumn (5 

.Minimum 

number 

of 

pounds 

Maximum 

number 

of 

pounds 

Maximum 

total 

.Maximum 
first 
shift 
in com¬ 
pressed 
air 

Minimum 

rest 

interval 
in open 
air 

.Maximum 
second 
shift 
m com¬ 
pressed 
air 

{•) 

IS 

8 

4 

'•2 

4 

18 

2(5 

(5 

3 

1 

3 

2r. 

33 

4 

‘> 

2 

2 

33 

38 

3 

Th 

ii 


38 

43 

2 

1 

4 

1 

43 

48 


H 

5 

H 

48 

.50 

1 

}2 

(5 

h: 


' Normal 


i)i:(:()MPKi:ssi()N 


No person employed in comi)ressed air shall be iiermitted to jiass 
from the place in which the work is being done to normal aii’, exccjit 
after decompression in the intermediate lock as follows: 

A stage decomjiression shall be used in which a droi) of one-half 
of the maximnm gauge pressure shall be at the rate of 5 pounds jier 
minute. The remaining decompression shall be at a uniform rate and 
the total time of decompression shall equal the time specified for the 
original maximnm jiressure. 

(a) Where the air pressure is greater than normal and less than 
15 ])Ounds to the scpiare inch, decompression shall be at the minimum 


rate of iiounds jier minute. 

{})) Where the air pressure is 15 iiounds or over and less than 20 
pounds to the sipiare inch, decompression shall be at the minimum rate 
of 2 pounds ])er minute. 

(c) Wliere the air ])re.ssure is 20 ])ounds or over and le.ss than fiO 
j)ounds to the sipiare inch, decom])ression shall be at the minimum rate 
of 3 pounds every 2 minutes. 

{(1) Where the air pressure is 30 pounds or over to the .scpiare inch, 
decompression shall be at the minimum rate of a i)ound per minute. 
The time of decomi)ression shall be posted in each man lock. 


(c) Where air pressure reaches seventeen pounds, a record of all 
men working in the air chamber shall be kept by a man detailed tor 
that purpo.se, who shall remain outside the lock, near the entrance. 
This record shall show the i)eriod of stay in the air chamber of each 
person and the time taken for decompression. 


10 . Rdiliant Energy 

_ Wherever avy ff/pe of radiant enenjji is emitted ndo an 

occupied area, provision shall be present to prevent these radiations 































fi'o^n injuring ani/ part of the body or reducing in efficiency the nonual 
function of (My part of the body. 

Purpose op JvULE. —Outside of visible liti’ld tbere Jire u iimiilxM* ot 
known tyj:»es of radiation whieli l)y llieir ))liysieal etfeet may injure 
the eyes, the skin, or the body mechanism as a whole. The i)rinci|)al 
radiations in this categ'ory are infra-red and ultraviolet which are very 
close in wave leng-th to visual lig'ht, and X-radiation, which has an 
extremely short wave length. Classified with X-radiation and having 
similar effects are gaseous emanations from radioactive materials and 
other radiations such as alpha,. l)eta and gamma rays. Although X- 
radiation and its associated components are the most dangerous, (see 
maximum allowable concentrations), infra-red and ultraviolet are the 
most frequently encountered. The purpose of the rule is to reduce the 
likelihood of injury to workers using equipment producing radiation 
or to other workers who may be exposed due to their proximity to such 
equipment. 

Practices for Compliance with Pule.— Two general methods are 
available for reducing ex))osure of workers to radiation; namely, shield¬ 
ing and jiersonal protection. In the first place, all eijidiiment pro¬ 
ducing radiation should be isolated from the general work area by 
means of proper barriers. This will reduce the possibility of radiation 
reaching persons avIio are not intimately concerned with the equi])- 
ment which produces the radiation. 

Ultraviolet radiation is encountered industrially princi]ially in weld¬ 
ing, either electrically or with gas. Although the intensity of such 
ultraviolet radiation is reduced inversely as the square of the distance 
from the source, enclosures or barriers should be provided for welding- 
work to ])revent the radiation reaching others in the vicinity. At 
stationary welding operations, permanent or semi-permanent fire re¬ 
sistant walls should be erected around the o])eration, extending from 
a distance of one-half meter from the floor level to a]iproximately 
2 meters above the floor. The inside of such enclosures should b(‘ 
])ainted dull lilack to reduce reflection. For ])ortable welding equi])- 
ment movable shields painted dull black should be placed around th(‘ 
welding operation to ]irevent radiation from reaching other jiersons 
in the vicinity. 

Tnfra-red radiation is that produced by high tem])erature heat 
sources, sucli as glass furnaces, metal furnaces, and other tvqies of in¬ 
dustrial heating eipupment. These are usually permanent installa¬ 
tions, and either permanent or movable fire resistant shields should be 
so placed as to prevent the radiation from reaching the workroom in 
which they are located. 

Sources of X-radiation, either industrial or medical, should be 
located within enclosures which ])revent the incident of ])otentially 
reflected radiation from reaching other workers or the general public. 


120 


i^^nclosure for such equipment may be of concrete or lead, or of other 
material of ecpiivalent caj)acity to a})sorh tlie radiation. For X-ray 
eqiiij>ment up to oOO milliampcres capacity, a 2 millimeter thickness 
of lead or a 2 centimeter thicknes.s of concrete will i)rovide protection; 
up to 1,()()() milliamperes, 2 millimeters of lead or 3 centimeters of con¬ 
crete are needed. 


Personal protection for the operators of equipment which produces 
radiation should also be provided. Welders and heli)ers working with 
either electric or acetylene equipment should wear both eye protection 
and fire resistant clothing which covers the hands and body. Eye i)ro- 
tection may be provided by means of goggles or helmets, the latter 
being preferable, having a lens shade of sufficient density to allow 
clear vision of the object being welded while reducing intensity of 
light to the eye to the point where there is no glare. Suggested filter 
densities are shown in the following table: 

‘ ‘ Shade Nos. 3 and 4 filter lenses are intended for glare for reflected 
sunlight from snow, water, roadbeds, roofs, .sand, etc., for stray light 
from nearby cutting and welding operations, and for metal ])ouring 
and furnace work. 

‘‘Shade No. 5 filter len.ses are intended for light gas cutting and 
welding, and for light electric spot welding. 

“Shade No. 6 filter lenses are intended for gas cutting, medium gas 
welding, and for arc welding up to 30 amperes. 

“Shade No. 8 filter glasses are intended for heavy gas welding, and 
for arc cutting and welding exceeding 30 but not exceeding To ami)eres. 

“Shade No. 10 filter lenses are intended for arc welding and cutting 
exceeding 400 amperes. 

“Shade No. 12 filter glasses are intended for arc welding and cutting 
exceeding 200 but not exceeding 400 amperes. 

“Shade No. 14 filter glasses are intended for arc weldiug and cutting 
exceeding 400 amperes. “ 

Persons intimately working with X-ray equii)ment may be |)artially 
protected by the use of leaded clothing, particularly gloves and a|)rons. 
So far as possible, persons operating X-ray ecpiipment should work 
from behind the enclosing barrier. This implies that the controls for 
such equipment are outside of the room which houses it. It should b(‘ 
emphasized that, as far as po.ssible. ])rotection from X-rays and similar 
radiations should be of a permanent nature and should be obtained 
by engineering control measures incorporated in the design and instal¬ 
lation of the equipment. 

(See tables 3 and 4, pp. 28 and 29, in American Standards Associa¬ 
tion: Safety (‘ode for the Industrial I sc of X-rays. Part 1. /;)4.1. 
1940. 70 East Forty-fifth Street, New York 17, N. Y.) 


II. J'entilation 

Utu.E. — Where excessive amounts of contaminants may be tiberated 


121 


into the atmosphere of occupied areas, adequate ventilation systems\ 
for their removal shall be installed, niaintaiaed la good conddion, and,I 
operated ejficiently at (dl times when work is being done. 

The discharge air of a ventilating system shall not be permitted to 
re-enter the same or other working areas and, shall not constitute a 
health hazard or nuisance in the community. Plans and specifications 

for all ventilating systems shall be submitted to the . 

. for approval prior to their installation. 

Purpose op Rule. —One of the accepted means for reducing atmos¬ 
pheric contamination is by the use of ventilation. Many materials and 
processes used industrially have been found to have harmful effects 
on the body (see section of maximum allowable concentrations). The^ 
purpose of this rule is different from that in the section Temperature, 
Humidity, and Air IMovement. In many cases, ventilation must he 
provided to remove from the working atmosphere industrial con¬ 
taminants which may be harmful. It is essential that such ventilation 
systems be properly designed and adequately maintained to accomplisli 
their purpose. Any contamination removed from the working environ¬ 
ment by such ventilation systems should not be allowed to re-enter the 
working place nor should it enter any other inhabited ai*ea in suffi¬ 
cient concentration to be harmful or to create a nuisance. 

Practice for Compliance with Rule.— Two types of ventilation may 
be used for removal of contaminants from occupied areas; namely, 
general dilution ventilation and local exhaust ventilation. General 
ventilation implies that the air in occupied areas is changed frequently, 
so that fresh air replaces contaminated air. Such air changes must in¬ 
sure that contamination in the Avorkroom is maintained below the 
maximum allowable concentration. UsiialA this requires a larger 
volume of air than the amount suggested in the section on Tempera¬ 
ture, Humidity, and Air ^Movement. Frequently general ventilation 
alone is not a satisfactory means of providing a safe environment but 
is only sup])lemental to other means. For example, in mining opera¬ 
tions Avet methods of dust control slioiild be utilized to jireA^nt exces¬ 
sive contamination of the air, and general ventilation as a supple-; 
mental means to remove from the Avorking space the incidental dust 
Avhich is produced even Avitli the proiier use of Avet methods. 

General ventilation may be induced either by natural means or by 
the use of fans and bloAvers to force air into or out of the Avork place. 
Where either general or local exhaust ventilation is used, it is neces¬ 
sary to insure that the air inlets are approximately equivalent to the 
air outlets. This Avill insure that excessive resistance to air motion does 
not occur oA’er the ventilation system as a aaRoIc. 

Local exhaust A^entilation is a means for removing air contamination 
at or near its source so that such contamination does not enter the air 
of the working area. The component parts of a local exhaust ventila- 


122 






tion s\steni are: (1) the hood into which the contaminant is directed; 
(2) the i)i|)in‘j: system for transportation of the contaminant to a 
l)oint of safe dissipation; (;5) the air movin<? mechanism to move air 
and contaminants through the system; and (4) in some cases a collec¬ 
tor for in-eventin" dispersal of the contaminant into the surrounding 
atmosphere. 

1 he hood of a local exhaust ventilating system may take many forms, 
but must be designed properly to collect the contaminant at its source. 
1 he more nearly a hood encloses the source of contamination, the 
more nearly it will accomplish its i)urpose. Complete enclosure is not 
always possible because of the recpdrements of the work. Other tyi)es 
of hoods include i)artial enclosures, canopy types, booths, open-end 
pipes, and open-end pipes with flanges. Tlie variations ot* these hood 
types must be S])eciflcally adapted to the work for which they are 
designed. 

The piping system should he so designed that the air and contamina¬ 
tion moving through it does not encounter excessive resistance. The 
piping system should extend from the hood to a safe point of discharge 
in the atmosphere outside of the working place. Tt should he main¬ 
tained so that all joints are tight and so that solid material does not 
collect inside, thus reduciiig the flow of air. Tiemoval traps may be 
installed in the ])i])ing system to collect solid materials. Clean-out 
openings may he installed at such points that cleaning of the inside 
of the piping is j)ossihle. 

The air-moving force may he either natural or induced fans or 
ejectors. A natural air-moving mechanism implies that a temj^erature 
dilferential exists which will create a movement of air into the hood 
an l piping system or that some other natural force such ns wind may 
be utilized, fn such installations, the stack must always he of a large 
diameter and vertical, without bends, which impose resistance to the 
air movement. For the most j^art, induced air movement by the use 
of blowers is the most satisfactory means for removing contaminants. 

The fan or ejector should be of sufficient ca])acity to move the 
necessary volume of air through the hood, piping system, and collec¬ 
tor. Resistance to air movement will be encountered at the hood open¬ 
ing, within the pipe, at pipe bends and at transition points. The volume 
of air which must be removed through the system will depend upon 
the proximity to the source of contamination. 

Collectors may he utilized in this type of system to remove dusts, 
fumes, vaj)ors, or gases from the air in the system before it is dis¬ 
charged to the atmos])here. They are not a necessary ])art of the sys¬ 
tem provided that the air is discharged in such a way that it will not 
reenter a working area or contaminate the general environment. For 
the most part, the discharge point of a ventilation system should be 
completely outside of the working area and ])referably above the roof 


123 ( 


line. If ventilating systems (liseliar^'<* liol'izontally. tlie (liseliar^(‘ j)oint 
sliould be at least three metei's distant from the nearest hnilding 
openinjr. 

J2. Respirato^ry Protective Equipment 

IvULE.— When exposures to exeessive uuiounls of ahnosphene eon- 
iaiuuKiuts are intermittent amt of f>nef duration, (ir where ventdation 
or other eontrol methods are impraetleal, the workers shatl be pro¬ 
tected by means of respiratory prideetire etiuipment. Such equipment 
shall (jive adequate protection against the specific contaminant under 
the condilions enconntered and shall be of a tiype approreil by the 

Itespiratory protective equipment shall be employed only under the 
conditions above stated and shall not be used in hen of other control 
methods of a more effective and permai\enl character. 

Puiii’osE OF Rule. —In the ahsenee of mon* janmianent tyi)es of eon- 
trol proeednres as a j)roteetion against atnios{)herie eontaminants, ap¬ 
proved respiratory ])i*ot(‘etiv(‘ e(pii})ment will ensure the health of 
the worker. 

' Phautk’Es fok ('omfinance Wi'iii Rui.e. — It is generally eoneeded 
that in tin* eontrol of exposures to harmful atmosj)heric eontaminants, 
first consideration should he piven to procedures for preventing con¬ 
tamination of the ail- to a harmful degr(*e in the breathing zone. How¬ 
ever, there are situations where for various reasons such jirocedures 
may he inapjilieahle, impraetieahle, oi- not etteetive. For these situations 
resjnratory protective ecpiipment may he indicated, either as a primary 
method or as an adjunct or suiiplement to other ])rocedures. 

■ The following classification of restiiratory protective equipment will 
serve to elucidate the various types of respirators, their general design 
features and the protection provided in various situations: 

RESPIRATOR CLASSIFICATION 


Respirator 

I. Air-purifying respira¬ 
tors . 


A. Chemical-filter re¬ 
spirators . 


General design featuies 
Filtei' (chemical or mechanical, 
for removing contaminant oi- 
contaminants from inhaled 
air) and face piece attached to 
filter directly or by means of 
short length of flexible rubber 
tubing. Entire device is car¬ 
ried by the wearer. 


Urotection provided 
Against specific contami¬ 
nants or types of con¬ 
taminants. No protec¬ 
tion against a t m o s- 
pheres deficient in oxy¬ 
gen. 


Canisters or cartridges contain- Against gaseous contami- 
ing suitable chemicals at- nants. 
tached directly or by means 
of short length of rubbei- tub¬ 
ing to full face piece or half 
mask. 


1. Gas Ma.sk 


Canisters with chemicals for in¬ 
dividual gases or combina¬ 
tions thereof. 


Up to 3 percent'ammonia 
and 2 per-cent most 
other gases and/or 
vapors. 


124 








KKSPIKATOK CLASSIFICATION — Continued 


is. (."heniical-cartiiilKe 
respirators . 

IJ. Aleclianioal-ttlter I'e- 
spiiators (commonly 
callecl (lust respira- 
tors) . 

jl. l>ust . 


2. Fumes 


3. Mist 


C. Cliemical and me- 
chanical-filter 
respirator . 

II. Supplied-air respira¬ 
tors 

A. Hose m a s k w i t h 
blowei'. 

U. Hose mask without 
blowei*. 


C. Air-line respirators.. 


D. Abrasive blasting... 


Cartridges with chemicals for 
Individual ga.ses or combina¬ 
tions thei-eof. 

Filjrous filter attached to half 
mask face piece directly or by 
means of a shoit length of 
rtexib’e rubber tubing. 

Fibi’ous filter attached to half 
mask face piece diicctly or by 
means of a shoj-l length of 
flexible rubbei' tubing. 

Fibi’ous filter attached t(t half 
mask face piece diiectly or by 
means of a short length of 
flexible lubber tubing. 


Fibrous filter attached to half 
mask face pi(‘ce directl.v or by 
means of a short length of 
flexible lubbei’ tubing. 


Chemical and mechanical filter 
attached to face piece directly 
or* by means of a short length 
of flexible rubber tubing. 


Blower (manual or power-oj)- 
erated) large diameter ho.se, 
harnes.s, and face i)iece. 

Barge diameter hose, hainess 
and face piece. 


Air supplied from special sys¬ 
tem or compressed air line to 
wearer through small diam¬ 
eter high pressure hose, re¬ 
ducing valve, short piece of 
flexible rubber tubing and 
face piece. 

Features same as 1, 2, 3 above 
(3 is more common) but in 
addition this device has suit¬ 
able hood to protect wearer 
against rebounding abrasive. 


Against very low or nui¬ 
sance concentration of 
gases and/or vapors. 

Against i)aiticulat(* con¬ 
taminants. 


Agjiinst dusts of all kinds. 


-Vgainst fumes of various 
metals. Since fumes are 
probably more difficult 
to remove by mechani¬ 
cal filtration than otlier 
kinds of |)articulate 
matter with the pos- 
s i b 1 e.xception of 
smokes, this respirator 
will |>i()tect again.st 
such particvdate matter 
as dusts and mists. 

.\ gainst m i s t s a s p r o - 
duced b.v s|)ray-coating 
with |)aint and vitreous 
enameks, cliromic acid 
mist as produc.ed in 
chromium plating, and 
mists of other materi¬ 
als who.se liquid vehicle 
does not |)roduce hai’m- 
ful gases or vai)ors. 

.\gainst combinations of 
gaseous and particulate 
cotita min,ants. 


.Vgainst any atmosphere. 


Against any atmospliere, 
but should not be used 
in immediately harmful 
atmospliere. 

Against any atmosphere, 
but should not be used 
in immediately harmful 
jitmospliere. 


S.ame as 1, 2, or 3 above, 
depending upon feii- 
tures but in addition 
has protection against 
impact and abrasion 
from rebounding abra¬ 
sive materi.al. 

















At the present time there has been developed in the United States 
by the United States Bureau of IMines a very rigid approval schedule 
for the testing of respirators of all kinds. Out of the extensive studies 
and tests made by this agency have resulted the standards necessary 
to determine the effectiveness and suitability of the various types of 
respiratory protective ecpiipment. ! 

In selecting respiratory protective devices care should be taken to : 
ensure that each device is designed and approved for use against the 
specific toxic material encountered and under the condition in which ', 
it is encountered. No gas mask, chemical cartridge type respirator or • 
mechanical fdter type res])irator will sustain life in an atmosphere 
deficient in oxygen, and even supplied-air respirators or hose masks 
should not be used in such locations unless the worker is protected by , 
a lifeline operated by another worker located in a safe place. | 

Personal respiratory protective devices must be maintained in a 
condition that is substantially the same as when received from the i 
manufacturer. Proi)er maintenance requires a thorough knowledge of ^ 
the device and should be performed by a responsible person. Failure to 
keep such devices clean and in efficient operating condition is re-' 
sponsible for much of the resistance of Avorkers to wearing the equip-1 
ment, and thus for failure to provide the protection intended. Neglect 
also makes it necessary to replace the equipment more frequently. The 
equipment should be stored in a clean, dry place where it Avill not be 
tampered with and where it will be con\^eniently available Avhen the 
emergency arises. Where a good deal of such equipment is in use, it 
is a good plan to give definite responsibility to one person for the 
periodic inspection, checking, and maintenance of such equipment. ;1 
Good rules to folloAv Avith regard to the maintenance of respiratory ] 
protective equipment are : i 

(a) Ahvays give the same device to the same person. 

{h) IlaA^e a definite place to leaA^e dirty^ devices and to pick up clean I 
ones. 

(c) Establish a maximum length of time the respirator may be used | 
before it must be serviced and cleaned, and keep a record of the dates j 
AA’hen insi)ected. j 

{(1) Establish a simple effectiA^e method of sterilization at regular « 
intervals. : 

In tliose cases Avhere Avorkmen have been properly informed regard- ( 

ing the need to Avear res])iratory protective equipment and have been 
trained in tlie proper use of such equipment, A^ery little resistance to 
the Avearing of the equipment is encountered. For this reason it is 
imi)oriant that an educational program be inaugurated among the 
Avorkmen AAuth regard to the acceptance and use of respiratory protec¬ 
tive devices. In this case, as with the general use of hygiene in indus- | 
try, there is a definite responsibility to be assumed by both the em- ^ 


126 







ployer aucl the employee. The employer should understand the opera¬ 
tion performed by the workman and the hazards involved. He should 
be acquainted with the design, ii.se, and limitations of protective 
equipment. Where such equipment is needed he should provide it and 
it should be of good and approved quality. The workman should also 
be instructed personally as to the need for wearing the equipment and 
how to use it properly. The employer should maintain the equipment 
in good, clean, serviceable condition, and its use should be carefully 
supervised. If the employer faithfully and properly responds to these 
responsibilities, the workmen, on the other hand, should accept the 
responsibility for wearing the device in the most effective manner. 
Satisfactory use of personal respiratory protective devices cannot be 
obtained without this mutual acceptance of responsibility and coopera¬ 
tion. 

All too frequently employers are prone to fall back on resj)iratory 
protection as the only means of safeguarding the health of employees. 
It should be considered that, at best, respiratory protective equipment 
is only a stop-gap, or a temporary means of protection, and should 
never be employed where other more permanent methods can be used, 
such as local exhaust ventilation or wet methods as in the case of 
dusts, supplemented perhaps by general ventilation. It is unfair to 
request anj^ workman to use a respiratory protective device through¬ 
out an 8-hour day, especially in warmer seasons, when even the best 
devices are uncomfortable and may at times be responsible for skin 
diseases. 

13. Protective and Perstninl Clothing and Equipment 

Rule.— Workers in operations, processes or cimditions of work which 
unduly expose them to dampness and wet environments, excessive 
heat, excessive noise, hazardous radiations, and other eye hazards, skin 
irritants, falls, falling material and other hazards, shall he provided 
with proper protective clothing and other devices of a type approved 
hy the . 

Purpose of Rule. —Some industrial operations require a potential 
exposure of the workmen to various hazards. Where protection is not 
})ossible by other methods, proper protective clothing should be pro¬ 
vided to the individuals so that the exposure will be reduced. The 
purpose of the rule is to in.sure that such devices are of the proper 
type for the exposure and are ])roperly maintained. 

Practices for Compliani’K with Hulk.— Personal protective devices 
have been mentioned in the sections on Temperature, Noise, Radiant 
Energy, and Skin Contact. Further protective devices include those 
which give protection against falling materials, against splashes of 
liquid chemicals, against excessive dampness and against falls. 

Head protection against falling material may be provided by means 
of hard hats. Such head gear should be of a rigid material which will 

SISJUS—19—10 



deflect falling objects and will protect the head from the shock from 
such objects. 

Facial protection may be provided by means of goggles, shields 
which cover the entire head and shoulders or face shields. Such facial 
protection should allow full vision and comfort. Full head shields may 
be made of various fabrics with a transparent face piece allowing 
vision. Face shields may be of plastics which allow full and undis¬ 
torted vision and whicli are provided with head band for support or a 
handle for holding it in position. Goggles may be used for protection 
of the eyes alone against flying objects, radiation, or splashed liquids. 
The lenses of such goggles may be of a hardened shock-resistant glass, 
or of other durable material which allows free and undistorted vision. 
They should give actual protection against tlie hazard, and, if neces¬ 
sary, should be of a cup type which closel}" fits the face to exclude 
extraneous materials completely. 

Protective clothing for the body may include: gloves, armlets, 
jackets, aprons, or complete body covering such as coveralls. Such 
items should be designed to protect the parts of the body which may 
be exposed to the hazard. As a guide for selection of types of materials 
which best protect against certain tyi)es of hazards, the following list 
of materials is cited: asl)estos fabrics—fiame resistant; treated cotton 
fabrics—flame and alkali resistant; clirome leather—heat and flame 
resistant; woolen fabrics—heat, flame, and acid resistant; rubber— 
water, acid, mild alkali, and electric current resistant; neoprene— 
solvent and oil resistant; other synthetic plastics—water, solvent, oil, 
and acid resistant. 

Protection for the legs and feet may be provided by means of leather 
and rubber shoes and boots and by leggings. 

The maintenance of protective clothing and equipment is a very 
important part of its use. Without proper maintenance such equip¬ 
ment may in itself become a hazard or may completely fail to provide 
the protection for which it was designed. Furthermore, protective 
equipment which contacts the body must be kept clean in order not to 
create a nuisance or any insanitary condition. 

As criteria for the selection of protective clothing and equij)ment. 
the following items must he considered: {a) the equipment should be 
reasonably comfortable under the temperature conditions in which it 
is to be used; (h) it should fit well and not interfere with the workers' 
activities; (c) it should afford adequate protection against the hazard 
involved; and (d) it should he durable. 

14. Housekeeping 

Rule.— The housekeeping in all occupied areas shall he such as to 
promote a healthful, and safe environment. 

Purpose of Rule.— Good housekeeping is, through order and cleanli¬ 
ness, an essential factor in assuring a healthful environment. 


128 





l*RACTicEs FOR (’oMpLiANCE WITH Kui-,E. —The etfectiveness of any 
j'ood housekeeping program depends in a large measure upon the 
thoroughness with which each person involved does his part. It is 
essential that such a program he inaugurated by management and that 
the workers he trained in their respective duties and obligations in the 
use of e(iuij)ment, methods and practices installed for the prevention 
of health and safety hazards. Another essential in a good housekeejiing 
program is a schedule of fre(]uent insi)ection to determine the degree of 
compliance with good practices. 

One of the important factors in introducing a good housekeeping 
program in a plant is the securing of orderliness. The plant should he 
so designed that the How of raw materials into it and the various stages 
of manufacture are arranged in such a manner that no congestion will 
result. I)isi)osal of scraj) and waste material must he adecpiate. In 
addition to a well-])lanned manufacturing process, it is important that 
proper storage facilities he })rovided for e(|ui]mient, tools, and raw 
materials. Unnecessary equit)ment and materials should he remov(*(l 
from working floors and surroundings. 

Thorough housekeeping means the removal of accumulations of dust 
from beams, pipes, and overhead structures, from shelving, from open 
storage platforms and fi'om the top of mechanical e(iuipment. It also 
means the removal of accumulations of dust and spilled materials from 
floors. Wherever possible, vacuum cleaning methods should he used. 
All cleaning should he done outside of working hours, or at such times 
as will keej) the exposure to dust to a minimum number of employees. 
Workmen engaged in cleaning operations and all others who may he 
exposed where dust is the offending agent, should he provided with 
approved dust respirators. 

Tn general, one may summarize good housekeeping for the control of 
occupational hazards by stating that in the first place it is everybody’s 
job. In sim])le terms it means maintaining an orderly and workman¬ 
like shoj), indoors and out. Some industries have found it useful to 
make someone in each workroom responsible for the housekeeping in 
that room. Others delegate that responsibility to sho)) health and safety 
committees. Whichever procedure is used, special attention should 
be paid to the following: (a) Tools should be kept in their assigned 
place, (h) Work benches should be orderly, (c) Materials should be 
brought to the operators and stacked in an orderly fashion, (d) Floors 
.should be kept free of trash, spilled oil. and other waste, (e) Aisles, 
.stairway.s, and halls should be kept free of obstructions. (/) Containers 
.should be kej)t closed, except when in actual u.se. {<j) Windows should 
be kept clean, {h) Lights should be cleaned and bulbs renewed jirompt- 
ly when indicated. (/’) Safety equipment should be kept in a.ssigned 
place.s, repaired and cleaned regularly. (./) Plant exterior, yards, store- 
hoirses, garages, etc., should always be kept clean, (k) Floors and other 


places where dust may settle should b(‘ kept clean by either wet 
sweeping or vacuum methods. 

15. Sanitation 

Rule. — The sanitation within all places of employment shall he such 
as to promote a healthf ul and safe environment. No insanitary condition 
shall exist which may increase the incidence or permit the spread of 
disease. The handliny, preparation and serving of food and drink shall 
be conducted in such a manner as to prevent the spread of disease. 

Purpose of Rule. —Good plant sanitation is essential in the preven¬ 
tion of communicable and other diseases. 

Practices for Compliance with Rule. —Plant sanitation is essen¬ 
tially concerned with («) Water supply, {b) Waste disposal, (c) Wash¬ 
ing facilities, (d) Toilet facilities, (e) Personal services, and (/) Ilouse- 
keeping. The latter subject has already been treated in this code. 

Water Supply. —Every place of employment should have a supply of 
clean, cool, A\diolesome and safe drinking water, approved by the local 
health authorities. The temperature of the water supply for drinking 
should not be lower than 4° C. nor higher than 27° C. and should be i 
preferably between 7° C. and 10° C. If the Avater is cooled by ice, the j 
ice should not come into direct contact AAuth the Avater. | 

Where sanitary drinking fountains are provided, they should be of j 
an approved type and construction and there should be at least one 
such fountain for each 50 employees. The common drinking cup is i 
])rohibited. Containers for drinking Avater from Avhich the Avater must 
be dipped or poured should not be alloAved, eA^en if they have covers, i 
Where AA^ater from an unapproved source is used for industrial proc- , 
esses or for tire protection, distinct notices should be posted stating i 
(‘learly that such Avater is unsafe for drinking. ■ 

Waste Disposal. —Waste receptacles of the type Avhich can be kept 
(‘lean and sanitary should be proAuded in all places of employment. | 
There should be an adequate number of such receptacles, and these • 
should be provided in or near all eating ])laces. Receptacles should be I 
covered, unless they contain nothing AAdiich Avill attract flies or rodents. | 
All Avaste recejitacles should be cleaned as often as is necessary to main- ■ 
tain them in a sanitary condition. All Avaste, including scAvage, should i 
be disposed of in a manner aiiproA’ed by the local health authorities. j 
Washing Facilities. —Adequati' facilities for maintaining personal | 
cleanliness should be furnisluHl in every ])lace of employment and j 
should be maintained in a sanitary condition. Sejiarate Avashrooms 
should be provided for each sex. At least one Avash basin Avith adequate 
Avater supply should be provided for eA'ery 10 employees or portion 
thereof up to 100 employees, and one Avash basin for each additional 
15 employees or portion thereof. TAventy-four inches of sink Avith indi¬ 
vidual faucet may be considered equal to one basin. At least one Avash 


130 




basin should be provided in each toilet room, unless general washing 
facilities are on the same floor or near to the toilet room. When* 
employees are exposed to skin contamination with poisonous, infectious, 
or irritating materials, then there should be provided for them, one 
wash basin with hot and cold water for every five employees and one 
shower with hot and cold water for every 15 employees. The common 
towel is prohibited. Soap, in a suitable dispenser, should he provided 
at each wash place. Oils or solvents used for removing contaminants 
from the skin should be used sparingly. 

loilet Facihfies .— Every place of employment should have adequate 
water closets, chemical closets or i)rivies, separate for each sex, in ac¬ 
cordance with the following table in which the numhei* of persons is 
the maximum of each sex. 


Number of jiersons 
employed 

1 to 9 
10 to 24 
25 to 40 
50 to 100 
over 100 


Miniuium number of 
toilet fa-f‘ilities 

1 


o 

o 

5 

1 for (‘aeli additional 
.‘)0 j)ersons 


Chemical closets and privies shoidd not be jtermitted except where no 
sewer is accessible and only when they can be kept under careful super¬ 
vision. An adequate supply of toilet ])aper in ])roper holders should be 
provided in each toilet room. Toilet rooms should lx* fitted with self- 
closing doors which should be screened from workrooms. The construc¬ 
tion and maintenance of t()ih*t stiMU'tures should comply with local 
h(*alth authority r(‘(piireme]its. 

Personal Services .—^In all j)laces of employment where it is neces¬ 
sary for male employees to change clothes or where females are em¬ 
ployed, sej^arate dressing rooms with lockers should be provided and 
maintained in a sanitary condition. Dressing rooms should be jirovided 
for men whenever the type of work is such that it involves ex|)osure to 
excessive dust, fumes, heat, vapors and other contaminants. 

Retiring rooms should be provided in all places where 10 or more 
women ai’(‘ employed. Where less than 10 women are employed and a 
retiring room is not furnished, some equivalent space should be pro¬ 
vided, which should be screened ))roperly and made suitable for the 
use of women workers. 

In every establishment where it is inc( nvenient for the employees to 
eat lunch away from the premises, ther^* should he provided a special 
lunch room. No employee should he permitted to eat lunch at his place 
of work or in the wmrkroom. Lunch K.oms should be maintained in 
clean and sanitary conditions. 


131 







C. Medical Provisions 


1. Prevention and Treatment of Occupational Illnesses and 
Injuries 

Rule.— Arrangements for facilities and services shall he present for 
the prevention and the prompt and early treatment of all illnesses and 
injuries resulting from occupational exposures. 

Purpose of Rule.— The purpose of medicine in industry is to pro¬ 
mote the health and physical well-being of industrial emploj^ees. 

These objectives may be accomplished by : 

{a) Prevention of disease or injury in industry by establishing 
proper medical supervision over industrial materials, ])rocesses, en¬ 
vironments and workers. 

(Z>) Health conservation of workers through physical supervision 
and education. 

(c) Medical and surgical care to restore health and earning capacity 
as promptly as possible following industrial accidents or disease. 

Practices for Compliance with Rule.— There is no industrial 
establishment too small to have an organized medical service. This has 
been definitely demonstrated in many countries where organized med¬ 
ical services have been developed for very small plants, say those em¬ 
ploying less than 500 workers, by organizing several small plants in 
close proximity to each other and furnishing them with an industrial 
' medical service by the utilization of local resources. Without such a 
medical organization and supervision, additional time is lost from acci¬ 
dental injuries, medical compensation costs are increased, and the 
establishment itself lacks the supervision and advice it needs in order 
to have adequate measures for health conservation. 

The scope and type of an industrial medical service will obviously 
depend upon the nature of the industry, its location, and the number 
of workers. In isolated communities it may be necessary to provide 
complete medical and hospital service for the workers and their 
families. 

The bulk of industrial medical service in a plant is given in the first 
aid room or dispensary. In order to maintain an adequate service, an 
industrial establishment will have to provide itself with one or more 
well qualified physicians to provide such service in the plant. The 
number of physicians and whether or not they serve full or part time 
will depend upon the number of workers in the plant. As previously 
indicated, small plants may combine to employ one or more physicians, 
or to secure the services of a group of physicians in the community on 
a rotating service plan. The dispensary should have one or more full¬ 
time or part-time qualified nurses who shall work at all times under the 
supervision of the physician. In case the physician is not present in the 
plant dispensary throughout the working period, then the nurse should 
have written standing orders signed by the physician. 


132 


<Ulier assistants, such as dentists, technicians, etc., whether on part- 
time or full-time basis, shall he employed as determined by the medical 
director. 

Kach plant shall have a dis])ensary of a size and arrangement and 
with e(jui])ment in accordance with the needs of the industry it serves. 
Detailed information on this score may be found in the references at the 
eiul of the appendix. 

Some of the functions mthI services ))erfoi*med at the i)lant dispensary 
are as follows: 

{(t) Emergency medical cai-c of all (miphn’ces who are injured on 
the job. 

(h) Continued treatment of (Mii|)lovees sntfering: from occupational 
diseases or a(*cidents. 

(c) ^laintenance and analysis of all disability records in order to 
know how, when, and why, lost time due to disability occurs in the 
])lant; these records should be tabulated monthly, accordiu" to cause, 
nature and duration of disabilities, and the de])artment of occupation 
of the juitient. 

(f/) All employees returning to work after an absence due to illness 
or injury should be examined in oi*der to determine their ca])acity to 
work'safely and efficiently. 

(c) The medical de|)artment in the plant has an unusual oi)p()rtunity 
to promote health education amonp: the employees, since an employee 
who is ill is in a recej)tive mood to absorb ^ood health practices. 

(/) The medical department should coo|)(‘rat(‘ with, and, if indi¬ 
cated, su|)ervise all other services in the |)la7it which relate to the health 
of the workers, such as food st*rvic(*, welfare si*rvic(*, and recreation 
|)ro<rrams. 

Adequate industrial health consei-vation depends on cooperation be¬ 
tween employers and em|)loy(H‘s. Tbe im‘dical de|)artment slmuld there¬ 
fore strive to ^ive these two groups the same courtesy and professional 
honesty as they would to jirivate |)atients. Industrial nurses and non¬ 
professional assistants should b(‘ supervised by the physicians, and 
their duties and functions should be described in clear and concise 
lan"ua"e, i)Osted in the medieal department. The physician should 
utilize the services of special consultants in the various branches of 
industrial medicine and surjrery and in the control of the working 
eiivironment. The latter service may lx* obtained from the. 


Medical and surjrical care of the worker should aim to restore the 
disabled employee to his former power and occu})ation as completely as 
science, skill, and nature will permit. It is the i)hysician’s responsi¬ 
bility to furnish concise and dejiendable medical reports promptly to 
those ajrencies responsible for the compensation and rehabilitation of 
the worker. 


J33 




The early diagnosis and treatment of any injury or disease is ex¬ 
tremely important. No attempt will of course be made here to outline 
the diagnostic and treatment procedures, but it may be well to mention 
that progressive medical departments have found it useful as an aid in 
diagnosis and treatment to utilize techniques of clinical laboratories. 
X-ray equipment and other useful adjuncts in the field of industrial 
medicine. 

2. Prevention and Treatment of ISonoccupational Illnesses and 
Injuries 

Rule.— Arrangements for facilities and services shall he present for 
the prevention and the prompt and early treatment of all emergency 
nonoccupational illnesses and injuries. 

Purpose of Rule.— First aid to the patient suffering from a non¬ 
occupational injury or illness will ofttimes permit him to remain on the 
job and will also serve to advise him regarding the need for outside 
medical care for an illness or an injury which, if not properly taken 
care of, may result in considerable loss of time from work. 

Practices for Compliance with Rule.— Ordinarily a plant medical 
service should not invade the field of private medical practice by pro¬ 
longed treatment of nonoccupational disabilities. Exceptions to this 
statement are those instances whore industrial plants are located in 
isolated communities where no other medical services are available, save 
those in the plant itself. In most instances, treatment on nonoccupa¬ 
tional injuries or illnesses should be limited to what is necessary to kee]) 
the emj)loyee on the job until he can see his own physician. 

3. Physical Examination 

Rule.— Every employer shall make available at no cost to a prospec¬ 
tive wo\''ker a preplacement health examination. 

Periodic health examinations shall he given to all workers requesting 
such examinations at no cost to the worker. In the case of workers 
exposed to toxic materials or hazardous conditions of work, such as 
those exposed to siliceous dusts, heavy metal dusts, or toxic solvents, 
the workers shall he examined as often as deemed necessary hy the 
examining physicmn, hut .wch examination must he given at least omce 
a year. 

In case the periodic examination shows the worker unfit for further 
work or for certain classes of work, thereby harring the worker’s future 
employment, then the latter may designate a physicmn of Jm choice 
and request a review of the findings. If the two physicians cannot agree 
in the findings, then a third physician, agreed on hy the two physicians, 
shall he selected and his findings shall he final. If the two physicians 

cannot agree on a third physician, then the director of the . 

. shall make the selection. 

Purpose of Rule.— Health examinations in industry are a means to 


m 







promote and maintain tlie physical and mental well-being: of the work¬ 
ers. More specifically, the objects of industrial health examinations are : 

((/) To facilitate j^lacement and advancement of workers in accord¬ 
ance with individual physical and mental fitness. 

{b) To acquaint the worker witli his j)hysical status and to advise 
him in imi)rovin" and maintaining: personal g:ood health, 

(c) To safeguard the health and safety of others. 

{(1) To determine and control Ihe effects of unhealthful working: 
environments. 

(e) To promote cooperative support and understanding: of indus¬ 
trial health practices by emjiloyer and emj)loyee alike. 

Practices for Compliance with Pule. —Cnjust or (juestionahle 
exclusion from Avork throug:h the employer’s application of the finding:s 
of the health examinations in industry is ag:ainst the public welfare 
and is contrary to sound industrial health princi[)les. From the public 
and industrial health AdeAV])oint, the only absolute bars to immediate 
employment in nonhazardous occupations are: communicable diseases, 
mental illness in Avhich imjiaired judg:ment or action prevents coopera¬ 
tive effort, and incajiacitating: injury or disease. 

Tn, scope, the industrial health examination should include such con¬ 
siderations as the worker’s past medical, family, and occupational his¬ 
tory. This latter is extremely im])ortant, in that it may throw con¬ 
siderable lig:ht on the Avorker’s present physical condition, Avhich may 
haA'e been impaired by previous hazai-dous employment. For example, 
a Avorker Avho has been exposed for a prolong:ed ])eriod of time to the 
inhalation of silica dust may, upon careful ])hysical examination, shoAv 
evidence of lung: impairment, Avhich Avould pi*eclude his employment in 
a dusty trade. It is essential, thend'ore, that the examining: ])hysician 
not only determine fi*om the prosjandive employee his jiast occiijiations, 
but he should also determine either from the em])loyee or from other 
sources, the nature of the hazardous exposures Avhich may be associated 
Avith the A'arious occu})ations. 

In addition, the examination should include ])hysical finding:s, ])er- 
.sonality apprai.sal, laboratory data, and th(‘ physician’s summary of 
finding:s and recommendations. 

One of the imiiortant objectives of the industrial health examination 
is the profier ])lacement of the Avorker. For this reason, the examiner 
Avill find that he may obtain best results Avhen he is thoroug:hly familiar 
with the industry he serves and the hazards of the industry. Such 
familiarity will only be obtained by the ])hysician throug:h periodic 
inspection of the industrial establishment he serves. Such inspection 
Avill also serve to locate hazardous plant conditions Avhich may be in 
need of correction. 

No attempt will be made in this discussion to set forth the equip 


ment necessary to conduct a thorouo-h health examination, nor to specify 
the routine procedure involved. 

It is important, however, to indicate briefly the use to which records 
of industrial health examinations may he put. In the first place, all 
major findings should he discussed with the worker, emphasizing the 
necessity for the latter to obtain immediate and ade(pTate medical care, 
if this be indicated. A transcript of the record may be sui)plied to the 
employee’s personal physician, or to an official health agency, on re- 
(piest or consent of the emi)loyee. The emi)loyer is entitled to receive i 
information regai’ding the man’s physical and mental cajmeity foi* 
work, so that the worker may be readily ])laced or promoted. A special 
simi)le form can be used for this j)urpose. The employei- should spe¬ 
cifically be told of any condition or disability found on the worker 
which ma}^ have been caused by the working environment, (fovern- 
mental agencies which recpiire the results of a ])hysical examination in 
connection with com])ensation ])rocedure should be furnished with a 
report, but only after ])resentation of a legally enforceable official order, j 

In all other cases there should be rigid observance of the confidential 
character of the health examination record and it should not be revealed 
to anyone excei)t on consent in writiiig of the worker himself. 

One of the most controversial points in labor-management relations 
in the field of industrial hygiene has been the })hysical examination. 
Until recently, neither management nor la])or has fully understood how 
to utilize ]n*o})erly the ]diysical examination as a technique for the 
improvement of health of the industrial worker. In the past, and in 
some instances even today, routine ]n*e})lacement and ])eriodic physical 
examinations have been made a management requirement, in order to : 
protect it in compensation litigation and to reduce the cost of iiisurance 
premiums. Labor, on the other hand, has insisted on contract clauses 
or laws designed only to protect workers against unfair use of the 
examination rather than making it a health service to the worker. We 
must recognize first that the ])hysical examination is more than a ’ 
medical ]:»roblem. It is also a socioeconomic ])roblem. The man who has 
spent his working life in one industry, and has accpiired seniority and 
a higher wage scale cannot be ex])ected willingly to accej)! placement 
in a less arduous but less remunerative job, even though it may save 
him from premature death due to a health condition discovered in the 
examination. Enlightened employers recognize this ])roblem eveii 
though they have not yet provided the answer. These problems can be 
solved if all interested groups get together and put their minds to it. 
The above rule dealing with the subject of physical examinations is, in : 
the opinion of competent authorities, workable, and is an' enlightened ' 
approach to this problem. Certainly that portion of it dealing with the | 
review of a periodic physical examination is reasonable and it should 
serve to protect both the employer and the employee. 


136 



I he purpose of periodic health examinations is to assist in maintain¬ 
ing: the health of tlie worker and to assure that Ids physical condition 
j is compatible with the recpdrements of the job. For these reasons 
I jieriodic jiliysical examinations should be made with sufficient thor- 
I ou<rhness and frecpiency, so as to jiermit early recognition of disease 
j while it is still in its incipient stajre. Such examinations are especially 
indicated for jiersonnel in key ])ositions and in the adult ajre fTrou]). 

I For those workers who are not exjiosed to hazardous conditions, an 
annual physical examination should be sufficient. On the oth(*r hand, 
there are many industrial ojierations and exposures which reipdri* moi*e 
freipient examinations. Althoufjrh in the final analysis, the frequency 
with which examinations are made will depend in a lar^re measun* on 
the judj^ment of the examining physician who, it is assumed, will hav(‘ 
a thorough knowledge of plant conditions and exposures, certain ex¬ 
periences have led to uniform practice in tin* matter of physical ex¬ 
aminations for workers exjiosed to toxic substances. 

These workers exposed to solvents, such as carbon tetrachloride, 
benzene and toluene, should be examined at the beginning of ex]K)sure 
and thereafter once a month. This monthly examination, however, need 
not be a thorough one, but only one which will indicate any early signs 
of poisoning. If good engineering ])ractices are in vogue and if ex¬ 
posures are slight, then the examination need oidy be every if to b 
months. Similarly, workers handling in any i)hase, compounds of lead, 
arsenic, mercury, cadmium, antimony, manganese, or other highly toxic 
material should be examined at least every if to b months. Workei*s 
exposed to mineral dusts such as silica, asbestos, etc., should be examined 
at least once a year, and this examination should imMinh* an \*-ray. 
])referably 14 by 17 inches in size. 

Workers exposed to radiation, such as from X-rays oi* radium painl. 
should be examined every b months. 

The examining physician will accpiaint himself with tlu‘ early diag- 
I nostic procedures for all of these highly toxic materials, so that his 
I periodic examination will be directed s])ecifically toward the search for 
any deleterious effects which the exposure may have on certain organs 
of the body. For example, in the case of exjiosure to radium there are 
now available sensitivity tests to determine the amount of radium in¬ 
gested by the body. Iflood studies may be utilized for these woi*kers ex- 
|)Osed to certain oi’ganic solvents. Certain i)i*ecise crit(*ria are available 
for determining if injury is resulting from lead (‘X|)osures and foi- 
many other of the heavy metals. 

In closing this discussion of preplacement and periodic physical 
examinations, it is essential to reiterate the objective of the examina¬ 
tion, which is to utilize every available worker. The old idea that an 
I industrial worker must have the physical requirements of a military 
i applicant is outmoded. Recent experience has demonstrated in no un- 


137 







certain terms tlie fact that j)e()j)le with certain piiysical handictaps can 
perform iisefnl work. A new concei)t has emerged from the intensive^ i 
study of jobs and workers, and from the i*esidts obtained in the place- | 
ment of the handicapped, l)y tlie rehabilitation clinics in highly indus- > 
Irialized countries. A new and ])ositiv(‘ a])proach has been developed 
which has made it possible to em])loy men hthI women with all tyf)es 
of physical handicaps. It has stimulated the use of scientific methods 
for assessing the capacities of the individual, the limitations of the job, 
and the means for matching the two. In this connection, applicants 
found infected with sy])hilis should be em])loyed, ])rovided the disease 
is at a noninfectious stage, and they have no other disqualifying com¬ 
plication, and that they remain under treatinent. ifg 

SELECTED INDUSTRIAL HYGIENE REFERENCES W 

Aldeii, L. J.: Desifj^ii of liidustria] Exliaust Sy.'^tem. Industrial Press, New Vorkjj 

American College of .Sui'g(ons: Medical Service in Industry and Workmen’s ConiQ^ 
pensation Laws, 40 Last Erie Street, Chicago 11, 111. 194(1. | 

American Conference of Governmental Industrial Hygienists, Ninth Annual Meet- I 
ing. J. J. Bloomfield, Secretary. IT. S. Public Health Service, Washington, D. C. i 
Report of Committee on Threshold Limits. 1947. i 

American Society of Heating and Ventilating Engineers: H('ating, Ventilating, - 
Air Conditioning Guide, 1946. 51 Madison Avenue, New York 10, N. Y. 

American Standards Association: Ameiican Recommended Practice of Industrial 
Lighting. A-11-1942. 70 East Forty-fifth Strc'et, New York 17, N. Y. \ 

American Standards Association: Safety Code* for Industrial Sanitation in Mann-! 
factiiriiig Establishments. Z4.1-1 OMo. 70 East Forty-fifth Sfia'et, New York 17, | 


N. Y. 1 

.\merican Standards Association: Safi'ty Code foi- tlu' Industrial Ptst' of X-rays.,' 
Part 1, Z54.1, 1946. 70 East Forty-fifth Stie('t, N(‘w Yoik 17, N. Y. 

Ameiican Standards Association: Specific Codes Relating to Safety. List of codes i' 
available thi-ough the Association. 70 East Forty-fifth Stread, New York 17, N. Y. : 
American Standards Association: Z.‘17 Codes on Allowabh* (’omamtrations. 70 East ‘ 
Forty-fifth Street, New York 17, N. Y. 

Behnke, A. R., Jr.: Noise in Relation to Hearing and Efficiency. New Wirk State 
Jour. Med., JO." lO.SO, 1940. 

Blake, R. P.: Industrial Safety. Prentie'e Hall, Inc., Ni'w York. 1944. 

Bloomfield, J. J.: Laboi’-Management Relationshi j)S in Industiial Health Ifi'oblems. 

Jour. Am. Med. Assoc., 128 : 6:59-64:1, June' :50, 1945. 

Coleman, J. A.: Vision Te.sts foi- Better Utilization of Manpower. Faeforv Man¬ 
agement and Maintenance, ,Iuly 1944. 

HallaValle, J. M.: How to Design Exhaust Hoods. P:n ts 1-12. Heat & Vent., ^0: 
41, March 194:i; 44, April 194.1; 8:i, May 194:i; 91, June 194:i; 65, .July 194:i; 
6.1, August 194.3; 79, September 194:>; 71, October 194.3; SO, Novendier 1943; 67, 
December 1943; Jf.1: 61, January 1944; 52, February 1944. 

Dart, Edward E.: Effects of High Speed Vibrating Tools on Operators Engaged 
in the Airplane Industry. Occup. Med., 1: 515-550, .June 1946. 

Fulton, W. J.: Records—The ‘'Seeing Eye” of Industrial Medicine. Indust. Med., 
13: 1-37, .Tanuarv 1944, 


138 






<T<>|«,lner, A.: OccupHtioiKil I)f*at’iu*ss witli Special Reference tn (’lirniiic Occupational 
Deafness. Arcli. Otolarvn^., 407, XoveinOer-Decemiier, 1945. 

Heinrich, H. W.: Iinlnstrial AccicUnit Prevention. McCtraw-Hill Hook (’o., Inc., 
New York. 1941. 

Hunter, J)., McLauj»hlin, A. 1. O., and Perry, K. M. A.: CMinical Effects of Us«- 
of Pneumatic Fools. Brit. ,Joui. Indnst. Med., 2: 10-10, .lanuarv 194,5. 

Industrial Hyjfiene Foundation: Sick .Absenteeism in Industry. Medical Series, 
Hull. Xo. 4. 4400 Fifth Avtuiue, Pittsburgh 13, Pa. 


International Labor Office, (xem'va and M’ashinjjton: Occupation and Health. En¬ 
cyclopedia of Hygiene, Pathology and Social Welfare. 19,30-34. 2 vols. and 

supplements. 

,I(dinstone, R. T.: Occupational Diseases. Diagnosis, Medicolegal Aspects and 
Treatment. W. H. Saunders Company, Philadelphia, Pa. 1942. 

McPllroy, G. E.: Engineering Factors in the Ventilation of Metal Mines. Hull. No. 
.385, Bureau of Mines, U. S. Dept, of the Interior. U. S. Govt. Print. Off., Wash¬ 
ington, D. C. 

New York State Department of Labor, Hoard of Standards and Appeals: Rules 
Relating to Work in Coni])ressed Air Tunnels and Caissons and Rules Relating to 
Tunnel Construction. Industrial Code Hidletins Nos. 22 and 22-A. 80 Centre 
Street, New York 13, N. Y. 

Sabine, H. J. and Wilson, R. A.: Apjilication of Sound Absorption to Factory 
Noi.se Problems. .Tour. Acoustical Soc. Am., 15: 27, 1943. 

Schrenk, H. IL: List of Respiratory Piotectivc' D(‘vices Approved by the Bureau 
of Mines. U. S. Bureau of Mines, W’ashington, I). (’. January 1941. 

Schrenk, H. H.: Testing and Design of Respiratory Protective Devices. I. C. 7086. 
U. S. Bureau of Mines, Washington, 1). C. 

Schwartz, Louis; Tulipan, Louis; and Peck, Samuel M.: Occupational Diseases of 
the Skin. 2d Edition, Lea and Febiger, Philadelphia. 1947. 

Sollmann, Torald: A MaJiual of I’harmacology. 6th Edition. W'. B. Saunders Co., 
Philadelphia. 1943. 

F. S. Department of Commerce', National Bure'.'iu of Standards: American Standard 
Safety Code for the Protection of Heads, Eyes, and Ri'spiratorv Organs. Hand¬ 
book No. 24. U. S. Govt. Print. Off., W'ashington, 1). C. Novemlier, 15>38. 

r. S. Department of Commerce, National Bureau of Standards: Safe Handling of 
Radioactive Luminous Compounds. Handbook No. 27, lt>41. U. S. Govt. Print. 

Off., W^ashington, D. C. 

I’. S. Public Health Service, Division of Industrial Hygiene: Manual of Industrial 
Hygiene. WMlliam M. Gafafer, Editor. W’. B. Saunders Co., Philadelphia, Pa. 


1943. 


F. S. Public Health Service: Skin Hazards in American Industries. Part I, Pub. 
Health Bull. No. 215; Pai t II, Pub. Health Bull. No. 22t>; Part 111, Pub. Health 
Bull. No. 249. U. S. Govt. Print. Off., W’ashington, D. C. 

Fnderwriters Laboratories, Inc.: List of Inspected Fire Protection Equipment and 
Materials. Available through the Fnderwriters Laboratori('s, Inc., 161 Sixth Ave¬ 
nue, New York, N. Y. January 1943. 

Wamph'r, F. The Principles and Practice of Industrial .M(*<lieine. Tin* W'illiams 
A W’ilkins f’o., Baltimore. 1943. 


^ U. S. GOVERNMENT PRINTING OFFICE: 194!)—818*118 



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